Status of Contralateral Ear in Patients with Unilateral Chronic Otitis Media

This study was conducted to evaluate the existence of otoscopic abnormality, hearing status and radiological changes in contralateral ear of patients with chronic otitis media. 300 patients having unilateral Chronic Otitis Media attending OPD in the Department of Otorhinolaryngology, Institute of Medical Sciences, Banaras Hindu University, Varanasi during the period of March 2019 to March 2020 were selected. Otoscopy, Pure Tone Audiometry and Bilateral X-ray mastoids (lateral oblique view) and/or HRCT Temporal bone were done. Contralateral ear was affected in more than 30% cases. Out of 188 patients having Mucosal COM, 58 cases (30.9%) had abnormal TM. Out of 112 patients having Squamosal COM, 48 cases (42.9%) had abnormal CLE. Out of 300 cases, 231 (77.0%) of them had normal hearing in contralateral ear. It was followed by 65 cases (21.6%) with conductive hearing loss. Mixed hearing loss and SNHL were seen in 2 patients each. In contralateral ear of Mucosal COM, pneumatic pattern of pneumatisation was seen in 69.1% followed by Diploic pattern (30.9%). In squamosal COM, X-ray mastoid showed pneumatic pattern (64.3%) followed by Diploic pattern (33.9%) in the contralateral ear. Sclerotic pattern was seen in only 1.8% of cases in contralateral ear. Chronic otitis media as a disease is not limited to one ear. The precise and critical evaluation of both ears does not play a role in prognostic evaluation of the patient only, but it can also serve as a guide for early detection of probable evolution of the disease process in a patient in contralateral ear with unilateral chronic otitis media.