VARIATIONS IN THE MIDDLE EAR ANATOMY INTRAOPERATIVELY IN PATIENTS OF CHRONIC OTITIS MEDIA

Abstract

Introduction: Middle ear is a very complex structure. Hence not only microscope but the use of endoscope is imperative to assess variations in its anatomy. With the same aim we are conducting the study focussing on variations in middle ear anatomy in CSOM patients not only clinico-anatomically but pathologically as well.

Materials and methods: Here we analysed total patient population of 36 of which 25 patients had chronic otitis media mucosal type and other 11 patients had squamosal type.

Observations: Subtle inter-subject variability was found between the patients in squamosal type vs mucosal type CSOM. Most of the patients had inter-subject variability where middle ear ventilation pathway was blocked as cholesteatoma was found near eustachian tube or near tensor fold or eroding varies ossicles. Thus, out of 11 squamosal 6 patients had blockade at the level of tensor fold anteriorly of which 4 cases were involving eustachian tube opening anteriorly as well. On the other hand when the middle ear mucosa was noted 5 patients of mucosal disease had congested mucosa while 7 has hypertrophic mucosa but only 3 had mucosa that was edematous.

Conclusion: Thus middle ear ventilation pathway blockade was more a feature of squamosal type CSOM while whereas mucosal type was associated with more clear middle ear ventilation pathways.