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Ossicular Chain Erosion in Chronic Suppurative Otitis Media

Hassan Haidar, Rashid Sheikh, Aisha Larem, Ali Elsaadi, Hassanin Abdulkarim, Sara Ashkanani,  Abdulsalm Alqahtani

Objectives: Hearing restoration surgery in chronic otitis media consists of myringoplasty for drum repair and ossiculoplasty for ossicular defect if present which carries a lower success rate and higher probability of revision surgery. Our objective is to evaluate the frequency of ossicular erosion in chronic suppurative otitis media which could be utilized to predict the probability of need for ossiculoplasty preoperatively then patients could be properly consented about these potential issues.

Materials and Methods: A prospective study was conducted in Otolaryngology unit of Hamad Medical Corporation. 279 ears that underwent surgery for chronic otitis media were studied and their ossicular status was reported.

Results: Ossicular chain was eroded in 66 (23.66%) out of the 279 ears. Erosion was more frequent in cholesteatoma ears (69.3%) than in safe ears (13.9%). The most frequently impaired ossicle was the incus and was found eroded in 62 (22.2%) ears. Malleus was found to be the most resilient ossicle and was eroded only in 13 (4.7%) ears. The stapes was eroded in 31 (11.1%) ears.

Conclusion: Our study shows that in chronic otitis media, approximately one-third patients have ossicular chain discontinuity. More than two thirds of patients with cholesteatoma have ossicular chain discontinuity. Otolaryngologists should be competent enough to do ossiculoplasty during ear surgery to give the best hearing results to their patients.