Contralateral ear findings in chronic otitis media
Suat Turgut2017, SiSli Etfal Hastanesi Tip Bulteni / The Medical Bulletin of Sisli Hospital
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Abstract
C hronic otitis media (COM) is a major health problem, especially in developing and underdeveloped countries. The chronic nature of the disease can lead to repeated hospital visits and increased financial burden, hearing loss, and related social problems concerning ear discharge, education/learning difficulties, and especially in untreated cases, life-threatening complications. COM is a disease that can affect both ears. Therefore, it is important to know the findings of the contralateral ears other than the affected ears to determine the changes in the tympanic membrane before the onset and during COM in this ear. For this purpose, the data of the patients who were operated on for COM between 2014 and 2017 were reviewed retrospectively. Otoscopic findings, audiologic examinations, and tomography images of the ipsilateral and contralateral ears of the patients were evaluated. Methods In this study, a total of 295 (131 females/164 males) patients who had been operated for the management of COM at the Objectives: Chronic otitis media (COM) reveals a spectrum of otoscopic findings, and both ears may be affected to a different degree. The analysis of contralateral ear in patients with COM is important to detect the early signs of the disease. This may enable the follow-up and treatment of abnormalities in contralateral ear without delay. Therefore, in this study, we aimed to investigate the otoscopic and audiologic findings of contralateral ears of patients with COM. Methods: The institutional data of patients who underwent surgical treatment between 2014 and 2017 due to COM were reviewed. Suppurative ears with cholesteatoma, polyps, and otorrhea refractory to medical treatment and ears with dry middle ear mucosa, with otorrhea responsive to medical treatment, and without cholesteatoma were divided into two groups (Group 1 and Group 2, respectively). All patients were examined with regard to the presence of perforation, retraction, myringosclerosis, atrophy, and audiological results before the groups were compared. Results: Approximately 50% of contralateral ears of patients with COM showed abnormalities at an otoscopic examination in both groups. Tympanic membrane retraction in Group 1 was greater than in Group 2, and the difference was statistically significant (p<0.05). Both the mean air and bone conduction thresholds of the contralateral ears in Group 1 were also found to be elevated when compared with Group 2, and the differences were statistically significant (p<0.05). Conclusion: COM may be seen bilaterally due to the same predisposing factors affecting the ears. Therefore, detection, followup, and early treatment of abnormalities of contralateral ear associated with otitis media have clinical importance in the prevention or delaying progression of these abnormalities to COM.
Key takeaways
- In the contralateral tympanic membranes of the patients in both groups (bad and dry ears), (1) perforation, (2) retraction, (3) myringosclerosis, (4) atrophy/pseudomembrane, or (5) natural examination findings were noted.
- Both groups were compared in terms of contralateral ear findings.
- Mild/moderate retraction rates in the contralateral ears in Groups 1 and 2 were 20.5, and 6.6%, respectively, with a statistically significant intergroup difference (p=0.001) ( Table 3).
- The rates of hearing loss in the contralateral ear were 63.4% in Group 1 and 46.4% in Group 2 (p=0.005) ( Table 3).
- An approximately 3 times higher number of retractions that was observed in the contralateral ear in the bad ear group and the presence of older patients in this group also suggest that the duration of the disease should be considered in retraction formation and in the progress to chronicity.
