Preoperative Predictors in Chronic Suppurative Otitis Media for Ossicular Chain Discontinuity: A Cross-Sectional Study

Audiol Neurootol. 2016;21(4):231-236. doi: 10.1159/000447045. Epub 2016 Aug 5.

Abstract

Objective: Ossicular discontinuity may result from chronic suppurative otitis media and is usually detected intraoperatively. Our objective is to determine whether a preoperative audiogram can preoperatively predict the presence or absence of ossicular discontinuity.

Methods: A cross-sectional study was prospectively run on our patients, aged 12-75 years, ultimately operated on for chronic suppurative otitis media. Preoperative audiograms were analyzed to measure frequency-specific air-bone gap (ABG) cutoff values. Intraoperatively, ossicular chain integrity was carefully checked. Logistic regression analysis was done to obtain a predictive model.

Results: A total of 270 patients (306 ears) were included. Frequency-specific ABG cutoff values can predict ossicular discontinuity, namely: high ABGs at 1,000 Hz (>27.5 dB) and 2,000 Hz (>17.5 dB) are the most reliable variables associated with ossicular discontinuity.

Conclusion: Preoperative audiograms can predict the presence of ossicular discontinuity in chronic suppurative otitis media. Large ABGs at both 1,000 and 2,000 Hz can predict ossicular discontinuity with a great degree of certainty.

MeSH terms

  • Adult
  • Audiometry, Pure-Tone
  • Bone Conduction*
  • Chronic Disease
  • Cross-Sectional Studies
  • Ear Ossicles / physiopathology*
  • Ear, Middle
  • Female
  • Hearing Loss, Conductive / physiopathology*
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Otitis Media, Suppurative / physiopathology*
  • Otitis Media, Suppurative / surgery
  • Preoperative Period
  • Prognosis
  • Tympanic Membrane Perforation / physiopathology*
  • Tympanic Membrane Perforation / surgery
  • Tympanoplasty*
  • Young Adult