INCIDENCE OF TYMPANOSCLEROSIS IN CHRONIC OTITIS MEDIA OF MUCOSAL TYPE: A CROSS SECTIONAL STUDY

Abstract

Introduction: Chronic Otitis media (COM) is one of the most common pathologies of the ear, causing high morbidity to the patient in terms of ear discharge and hearing loss initially, which may proceed on to various other symptomatologies. Many of the subjects suffering from COM have multiple degrees of tympanosclerosis, which, if not removed in total will obstruct the hearing mechanism. AIM: To know the incidence of tympanosclerosis in its various forms and involvement in chronic suppurative otitis media (CSOM) patients. SETTINGS AND DESIGN: The study was carried out in a Tertiary Hospital in Vizianagaram, Andhra Pradesh. It is a Prospective study, culminating in the treatment of the subjects. MATERIALS AND METHODS: Patients presenting to ENT OPD, from January 2019 to December 2019, and diagnosed as COM with Inactive mucosal disease were included in this study. All the patients were subjected to detailed ENT examination and investigations, otoscopic examination, and examination under a microscope. After due surgical investigations, the patients were subjected to explorative tympanotomy, sclerosis identified, and documented. RESULTS: Of the 122 patients included in the study, 24 patients had evidence of tympanosclerosis. (19.67%). Of them, 10(41.6%) were males, and 14(58.3%) were females. Seventeen patients (70.83%) were found to be having myringosclerosis; seven patients (29.16%) had sclerosis in the tympanic membrane and middle ear. In patients with myringosclerosis, the ossicular chain was found to be mobile in 14 (82.35%), discontinuous in 2(11.7%), footplate fixation in 1 (5.88%). In the 7 cases with sclerosis of the membrane along with middle ear, 3 (42.85%) cases had sclerotic patch at the body of incus, 2 (28.5%) cases had it at the head of the malleus, and the rest 2 (28.5%) had it dispersed. CONCLUSIONS: Tympanosclerosis is a known entity affecting patients suffering from COM, females more than males. It can be either affect the tympanic membrane, or either it can involve the middle ear, along with the tympanic membrane. Wherever the site of affection is, the surgeon must remove the sclerotic plaque, to give a better hearing to the patient.

Keywords: COM, EXPLORATIVE TYMPANOTOMY, INACTIVE MUCOSAL DISEASE, INCUS, MALLEUS, OSSICULAR CHAIN, TYMPANOSCLEROSIS