Study of ossicular chain defects in patients with chronic otitis media


  • Smita Soni Department of Otorhinolaryngology and Head and Neck Surgery, Gandhi Medical College, Bhopal, Madhya Pradesh, India
  • Anjali A. R. Department of Otorhinolaryngology and Head and Neck Surgery, Gandhi Medical College, Bhopal, Madhya Pradesh, India
  • Yashveer J. K. Department of Otorhinolaryngology and Head and Neck Surgery, Gandhi Medical College, Bhopal, Madhya Pradesh, India



COM, Ossicular chain defect, Tubo-tympanic disease, Attico-antral disease


Background: Chronic otitis media (COM) is a long-standing disease of middle ear cleft and mastoid cavity having a permanent perforation in the tympanic membrane with or without discharge. It’s a worldwide health problem and it is still predominant in the modern antibiotic era. Aim was to determine the prevalence and types of ossicular chain defect in mucosal and squamosal type of COM. Also, to evaluate the hearing loss in relation to ossicular chain defect.

Methods: The study was prospective observational study conducted in Bhopal over the duration of one year (January 2019 to June 2020). Patient aged 11-70 years reporting with COM were included in the study. Details regarding sociodemographic profile and extensive examination were recorded. Data was entered into MS excel 2007, analysis was done.

Results: It was more prevalent in the age groups of 21-30years (39%) with female (53%) preponderance. Right sided ear was commonly involved (58%). Majority of the patients had tubo-tympanic disease (62%) whereas 38% had attico-antral disease. Ossicular chain was found intact in 33% cases. Average hearing loss was maximum (67.6 dBHL) when all ossicles are eroded. Hearing loss was minimum (33.6 dBHL) with isolated handle of malleus involvement.

Conclusions: COM is one of the commonest causes of preventable hearing impairment in our society, hence early diagnosis and timely intervention is needed. Awareness among patients and doctors regarding the need for better ear hygiene is necessary.


Varshney S, Nangia A, Bist SS, Singh RK, Gupta N, Bhagat S. Ossicular chain status in chronic suppurative otitis media in adults. Indian J Otolaryngol Head Neck Surg. 2010;62(4):421-6.

Acuin J. Chronic suppurative otitis media-burden of illness and management options. Geneva World Health Organisation; 2004.

De Azevedo AF, Pinto DC, De Souza NJ, Greco DB, Gonçalves DU. Sensorineural hearing loss in chronic suppurative otitis media with and without cholesteatoma. Braz j otorhinolaryngol. 2007;73(5):671-4.

Pickles CF, James O. An Introduction to the Physiology of Hearing. 4th. UK: Emerald Group Publishing Limited. 2012.

Dawes JK. Myringoplasty. J Laryngol Otol. 1972;86(2):141-6.

Gleeson M, Clarke R, editors. Scott-Brown's Otorhinolaryngology: Head and Neck Surgery 7th Ed. CRC Press; 2008;3.

Mohanty S, Gopinath M, Subramanian M, Vijayan N. Relevance of pure tone average (PTA) as a predictor for incus erosion. Indian J Otolaryngol Head Neck Surg. 2012;64(4):374-6.

Bangera DR, Kulkarni SV, Dhawale AS. Clinical profile of ossicles in chronic suppurative otitis media: a study of 100 cases. Int J Otorhinolaryngol Head Neck Surg. 2019;5(4):978.

Hossain MD, Ahamed MN, Sumon MM, Shoyeb BA. Status of Ossicles in Cholesteatoma. Bangl J Otorhinolaryngol. 2015;21(2):97-101.

Balasubramanian C, Santhanakrishnakumar B, Anandan H. A study on ossicular erosion in chronic suppurative otitis media. Int J Scientific Study. 2017;5(5):94-7.

Kumar P, Samatha S. Correlation of Ossicular Chain Defects With Audiometric Profile In Patients With Chronic Suppurative Otitis Media Squamous Epithelial Type. J Evolution Med Dental Sci. 2017;6(92):6574-8.

Rao SR, Rao PR. A study on frequency of ossicular chain erosion in CSOM. Available at: Accessed on 2021 Oct 4.

Gurumani S. A study on ossicular defects in patients with tubotympanic type of CSOM. J Evolution Med Dental Sci. 2013;2(30):5521-6.

Rout MR, Das P, Mohanty D, Rao V, Susritha K, Jyothi BE. Ossicular chain defects in safe type of chronic suppurative otitis media. Indian J Otol. 2014;20(3):102.

Martins O, Victor J, Selesnick S. The relationship between individual ossicular status and conductive hearing loss in cholesteatoma. Otol Neurotol. 2012;33(3):387-92






Original Research Articles