Does The Type of Ossicular Chain Lesion Affect Outcomes in Chronic Suppurative Otitis Media Without Cholesteatoma?

We evaluated the pattern of ossicular chain (OC) lesion in chronic suppurative otitis media (CSOM) without cholesteatoma and its impact on outcomes in primary and revision surgeries.

This was a retrospective chart review. Patients who underwent tympanoplasty due to CSOM with OC defect between 2010 and 2015 were included in the study.

OC lesions were found during 40 of 147 tympanoplasties performed due to CSOM. The preoperative air-bone gap (ABG) was greater in both discontinuity and fixation cases than in cases with CSOM with an intact OC (p<0.001). Twenty-nine patients were followed up postoperatively, after excluding four patients with stapes footplate fixation, in whom stapedotomy was not performed simultaneously. Among the 29 patients, the audiological results were similar in cases of discontinuity and fixation regarding gap change, residual ABG, and the rate of successful ossiculoplasty. Primary tympanoplasties provided better results according to postoperative ABG and the rate of successful ossiculoplasty than revision surgeries (p<0.05); however, similar patterns of OC lesions were found during primary and revision surgeries.

Both OC discontinuity and fixation occur in CSOM in a similar distribution in primary tympanoplasties and revision surgeries. The type of OC lesion does not affect outcomes. Primary surgeries provide better results, but that is not due to a difference in the character of the OC lesion.