Intraoperative findings during canal wall down mastoidectomy in chronic suppurative otitis media at a tertiary care hospital, Sukkur, Pakistan

To assess the intraoperative findings during canal wall down mastoidectomy in patients for unsafe type of chronic suppurative otitis media [CSOM]. This prospective interventional study was carried out at Department of ENT and Pediatrics of Ghulam Muhammad Mahar Medical College Hospital, Sukkur, Pakistan from June 2009 to June 2011. Eighty patients who were 5-55 years of age, of both genders, with CSOM who underwent canal wall down mastoidectomy were included in the study. The operative findings like extent of cholesteatoma, granulation tissue in different location in middle ear cleft and ossicular chain condition and otogenic complication were identified. Females were affected more than males [n=48; 60%]. Granulation tissue was found in 50 [62.5%] of cases, while cholesteatoma in 30 [37.5%] cases. The extent of disease was attic in 4 [5%], attic and middle ear 30 [37.5%], attic and antrum 16 [20%] and attic, antrum and middle ear 30 [37%] patients. In majority of the cases there were involvement of more than one ossicle; among the most affected single ossicle malleus was found necrosed in 50 [62.5%], and absent in 6 [7.5%] cases, incus was found necrosed in 42 [52.5%], and stapes was found necrosed in 20 [25%] of cases. The primary disease found in our patients undergoing canal wall down mastoidectomy was granulation. Less common were cholesteatoma and multi-ossicular

Ossicular damage in chronic suppurative otitis media- study of 100 cases

To identify the extent of ossicular chain damage in chronic suppurative otitis media [CSOM]. Prospective study. This study was conducted at department of Otolaryngology-Head and Neck Surgery, Dow Medical College and Civil Hospital, Karachi. March 2003 to March 2004. 100 cases presenting with CSOM under going mastoid exploration. The age of presenting of CSOM undergoing mastoid exploration ranged from 5 yrs to 55 yrs. The most commonly affected group was between 11 yrs to 20 yrs [50%]. Females were affected more than male [60%]. All patients presented with chronic discharging ears having conductive deafness, 60% presenting with moderate degree of hearing impairment [31 to 50 dB] while 30% had less than 30 dB loss and only 10% had greater than 50 dB loss. Granulation tissue was found in 47 cases, cholesteatoma in only 30 cases, inflamed mucosa in 24 cases, polyps in 7 cases and tympanosclerosis in 3 cases. Handle of malleus was necrosed in 30 cases, while in 20 cases all the three ossicles were necrosed except the foot plate of stapes. Long process of incus and handle of malleus were missing in 10 cases and the long process of incus alone was necrosed in 5 cases while malleus and incus were missing in 5 cases. In 30 cases all the ossicles were intact and mobile. Multi ossicular chain damage is more frequent than single ossicle damage in cases of chronic discharging ears. It is also observed that cholesteatoma is less frequent than the granulation tissue and inflamed mucosa in our setup