Assessment of short term hearing improvement in patients of cartilage interposition ossiculoplasty for lenticular process of incus necrosis in cases of chronic suppurative otitis media: mucosal disease

Shashikant K. Mhashal, Neeraj R. Shetty, Amit S. Rathi, Vinod A. Gite


Background: Chronic suppurative otitis media is a highly prevalent disease in developing countries. Hearing loss associated with this disease is significantly more in cases associated with ossicular necrosis along with tympanic membrane perforation.

Methods: We would like to present a study of such cases of mucosal chronic suppurative otitis media associated with lenticular process necrosis treated by cartilage interposition ossiculoplasty. The patients were followed up for a minimum period of 6 months and their pre op and post op hearing was documented and analyzed.  

Results: An average air bone gap of 39.07 decibels in pre op was reduced to 18.13 decibels in post-operative period and these improvements persisted over 6 months of follow-up.

Conclusions: We have hereby concluded that the hearing improvement is comparable to other methods of ossiculoplasty with minimum disruption of natural hearing assembly in lenticular process of incus necrosis.



Ossiculoplasty, Cartilage interposition, Austin Kartush type A, Chronic suppurative otitis media, Lenticular process necrosis

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Kumar N, Chilke D, Puttewar MP. Clinical Profile of Tubotympanic CSOM and Its Management With Special Reference to Site and Size of Tympanic Membrane Perforation, Eustachian Tube Function and Three Flap Tympanoplasty. Indian J Otolaryngol Head Neck Surg. 2012;64(1):5-12.

Meyerhoff W. Pathology of chronic suppurative otitis media. Ann Otol Rhinol Laryngol Head Neck Surg. 1988;97(130):21-4.

Cummings C. Otolaryngology–Head and Neck Surgery. St Louis, Mosby-Year Book, 2nd ed. 1993;4:2830.

Paparella MM, Schumrick DA. Otolaryngology. 3rd edition. Philadelphia, WB Saunders Co., 1991.

Deka RC. Newer concepts of pathogenesis of middle ear cholesteatoma. Indian J Otol. 1998;4(2):55–7.

Sade J, Berco E, Buyanover D, Brown M. Ossicular damage in chronic middle ear inflammation. Acta Otolaryngol. 1981;92:273–83.

Bojrab DI, Balough BJ. Surgical anatomy of the temporal bone and dissection guide. In: Glasscock ME, Gulya AJ, editors. Glasscock-Shambaugh surgery of the ear. 5. New Delhi: Reed Elsevier India Pvt. Ltd; 2003: 778.

Merchant SN, Rosowski JJ. Auditory physiology. In: Glasscock ME, Gulya AJ, editors. Surgery of the ear. 5. New Delhi: Reed Elsevier India Pvt. Ltd; 2003: 70.

Varshney S, Nangia A. Ossicular chain status in chronic suppurative otitis media. Indian J Otolarngol Head Neck Surg. 2010;62(4):421–6.

Udaipurwala IH, Iqbal K, Saqulain G, Jalisi M. Pathlogical profile in chronic suppurative otitis media—the regional experience. J Pak Med Assoc. 1994;44(10):235–7.

Austin DF. Ossicular reconstruction. Arch Otolaryngol. 1971;94:525–35

Kartush JM. Ossicular chain reconstruction. Capitulum to malleus. Otolaryngol Clin North Am. 1995;27:689–715.

Shrestha S, Kafle P, Toran KC, Singh RK. Operative findings during canal wall mastoidectomy. Gujarat J Otorhinolaryngol Head Neck Surg. 2006;3(2):7–9.

Mathur NN, Kakar P, Singh T, Sawhney KL. Ossicular pathology in unsafe chronic otitis media. Indian J Otolaryngol. 1991;43(1):9–12.

Desarda K, Bhisegaonkar DA, Gill S. Tragal perichondrium and cartilage in reconstructive tympanoplasty. lndian J Otolaryngol Head Neck Surg. 2005;57(1):9-12

Chaudhary N, Anand N, Taperwal A, Rai A. Role of autografts in the reconstruction of ossicular chain in intact canal wall procedures.lndian J Otolaryngol Head Neck Surg. 2003:55(3):157-9.

Iurato S, Marioni G, Onofri M. Hearing results of ossiculoplasty in Austin-Kartush Group A patients. Otol Neurotol. 2001;22:140–4.