[Clinical investigation on anacusis associated with chronic suppurative otitis media]

To investigate the risk factors and clinical features of anacusis or severe deafness associated with chronic suppurative otitis media (CSOM ).

A retrospective review of 62 ears consecutive cases of severe deafness (15 ears) and anacusis (47 ears) associated with CSOM were investigated . There were 5 ears severe deafness deteriorated to anacusis after procedures. This represented 6.42% of our total series of CSOM with or without cholesteatoma in adults and children (965 ears) in 1993-2000. The series with cholesteatoma or granuloma or tympanosclerosis were 46 (74.19%) ears 13 (20.97%) ears and 3 (4.84%) ears respectively. The symptoms and operative findings were analyzed. All patients underwent preoperative CT scans and preoperative audiometry. With respect to surgical technique, the canal-wall-down procedure was performed in(50/62) 80.6%, and classical modified mastoidectomy was performed in(12/62) 19.4%.

The results demonstrated that chronic otorrhea with bloody, ossicular chain destructive and erosion of the supraplate structure or disappear of footplate were helpful predicting indicators for anacusis or severe deafness. There was a high significant association (Chi-square Fisher exact test P < 0. 001) with these factors compared with CSOM without anacusis or severe deafness. Labyrinthine fistula was also correlated to anacusis or severe deafness (P < 0.05). There were no significant with the courses and facial paralysis and revision mastoidectomy.

Anacusis or severe deafness intimately associated with chronic otorrhea with bloody, ossicular chain destructive, erosion of the supraplate structure or disappear of footplate and labyrinthine fistula. The surgical procedure should be performed earlier to eradicate the chronic or acute infection and to avoid anacusis or severe deafness.