Is ossicular chain fixation predictable for tympanosclerosis on preoperative temporal bone computed tomography?

Area of Science:

• Otolaryngology
• Radiology
• Medical Imaging

Background:

• Chronic otitis media (COM) with tympanosclerosis (TS) presents diagnostic challenges.
• Assessing ossicular chain (OC) fixation preoperatively is crucial for surgical planning.

Purpose of the Study:

• To evaluate the predictability of ossicular chain fixation using preoperative temporal bone computed tomography (TBCT).
• To determine if incudostapedial joint (ISJ) angulation on TBCT can predict OC fixation in COM with TS.

Main Methods:

• Retrospective case-control study of 56 patients undergoing COM surgery.
• Patients divided into groups with and without TS.
• Comparison of preoperative TBCT-measured ISJ angulation between groups and operated/healthy sides.

Main Results:

• Significantly greater ISJ angulation in the operated ear compared to the healthy ear in COM with TS (p < 0.001).
• No significant difference in ISJ angulation between operated and healthy ears in COM without TS (p > 0.05).
• ISJ angulation was significantly higher in the TS group compared to the non-TS group (p < 0.001).

Conclusions:

• Increased ISJ angulation on TBCT may indicate ossicular chain fixation.
• Preoperative TBCT measurement of ISJ angulation can predict OC fixation in COM cases with TS.