Preoperative predictors of ossicular necrosis in chronic suppurative otitis media, tubotympanic disease.

Jareen, Ann Ebenezer (2009) Preoperative predictors of ossicular necrosis in chronic suppurative otitis media, tubotympanic disease. Masters thesis, Christian Medical College, Vellore.


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Chronic suppurative otitis media (CSOM) refers to chronic infection (more than 6 weeks) of the middle ear cleft ( Eustachian tube, middle ear and mastoid ) in the presence of a persistent tympanic membrane perforation. (World Health Organization, 1998). There may be intermittent or constant purulent otorrhoea and mastoiditis. CSOM has been an important cause of middle ear disease since prehistoric times. Its prevalence depends to a great extent on race and socio-economic factors. Otologists, well aware of the potentially dangerous and life-threatening risks of otitis media, concentrate on treating the disease and rendering the ear safe. Hearing reconstruction often takes second priority. Patients, however, are more concerned about the hearing loss caused by this disease because the other subjective symptoms of CSOM may be minor or lacking. In conclusion, four pre-operative factors were found to be reliable, independent predictors of incus necrosis. These were, the presence of an actively discharging ear, foreshortening of the handle of the malleus, middle ear granulations and a pure tone air conduction average hearing loss of the moderate to moderately-severe range (40-70dB). Intra-operative findings of mastoid granulations and a blocked aditus were also highly significant, independent factors increasing the risk of incus necrosis. These four pre-operative factors and two intra-operative factors could be considered reliable indicators of incus necrosis in chronic suppurative otitis media without cholesteatoma.

Item Type: Thesis (Masters)
Uncontrolled Keywords: ossicular necrosis; chronic suppurative otitis media; tubotympanic disease; preoperative predictors
Subjects: MEDICAL > Otolaryngology
Depositing User: Devi S
Date Deposited: 11 Jul 2017 10:44
Last Modified: 11 Jul 2017 10:44

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