Ossicular Chain Erosion in Chronic Suppurative Otitis Media Hassan Haidar, Rashid Sheikh, Aisha Larem, Ali Elsaadi, Hassanin Abdulkarim, Sara Ashkanani and Abdulsalm Alqahtani Otolaryngology Department, Hamad Medical Corporation, Doha, Qatar * Corresponding author: Hassan Haidar, Otolaryngology Department, Hamad Medical Corporation, Doha, Qatar, Tel: 305033406608; E-mail: hassanhaidarmd@gmail.com Received: June 02, 2015, Accepted: July 29, 2015, Published: July 31, 2015 Copyright: ©2015 Haider H, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Objectives: Hearing restoration surgery in chronic otitis media consists of myringoplasty for drum repair and ossiculoplasty for ossicular defect if present which carries a lower success rate and higher probability of revision surgery. Our objective is to evaluate the frequency of ossicular erosion in chronic suppurative otitis media which could be utilized to predict the probability of need for ossiculoplasty preoperatively then patients could be properly consented about these potential issues. Materials and Methods: A prospective study was conducted in Otolaryngology unit of Hamad Medical Corporation. 279 ears that underwent surgery for chronic otitis media were studied and their ossicular status was reported. Results: Ossicular chain was eroded in 66 (23.66%) out of the 279 ears. Erosion was more frequent in cholesteatoma ears (69.3%) than in safe ears (13.9%). The most frequently impaired ossicle was the incus and was found eroded in 62 (22.2%) ears. Malleus was found to be the most resilient ossicle and was eroded only in 13 (4.7%) ears. The stapes was eroded in 31 (11.1%) ears. Conclusion: Our study shows that in chronic otitis media, approximately one-third patients have ossicular chain discontinuity. More than two thirds of patients with cholesteatoma have ossicular chain discontinuity. Otolaryngologists should be competent enough to do ossiculoplasty during ear surgery to give the best hearing results to their patients. Keywords: Ossicles; CSOM; Erosion; Cholesteatoma Introduction Chronic Suppurative Otitis Media (CSOM) is a prevalent middle ear pathology that constitutes of tympanic membrane perforation together with a chronically inflamed middle ear mucosa. CSOM can occur with or without cholesteatoma which is an in- growth of eardrum skin into the middle ear cavity. CSOM is the leading cause of conductive hearing impairment in adults which is secondary to damage of the ear drum and middle ear ossicles induced by chronic inflammation present in the tympanic cavity. Ossicular erosion, a frequent complication of CSOM, may lead to total failure of middle ear mechanics and resulting in substantial hearing loss [1]. Hearing restoration surgery comprises ear drum repair and ossicular chain reconstruction in ears housing defective ossicles. The later scenario is associated with higher rate of long term acoustic failure that may reach 50% [2,3]. Myringoplasty in the absence of ossicular damage is bracketed with a much higher long-term success rate more than 90% even in wet ears [4]. Ossicular integrity or erosion can only be confirmed intra- operatively. The preoperative information given to the patient must be comprehensive, and should include details of the probabilities of having OCD and the associated risks of acoustic failure and need for revision surgery. This study was conducted to assess middle ear ossicles state of in 279 ears that required surgery for CSOM. The findings of this study could be exploited to predict preoperatively the probability of having OCD in CSOM ears and thus patients could be therefore properly consented about these potential issues before surgery. Materials and Methods Ethical approval for this study was received from the JIRB (Joint Institutional review board) of our institution (IRB Number 14-00133). We conducted a prospective study in our institution in the period running from January 2014 to June 2015. Patients older than 18 who underwent tympanoplasty for CSOM during this period were recruited to our study. Patients younger than 18 or posted for revision tympanoplasty were excluded. Written informed research consent was obtained from recruited subjects. Recruited subjects were interviewed preoperatively by the senior author for history taking and proper ear examination. Intraoperatively, all patients had proper exploration of middle ear using microscope and endoscope looking and the status of each ossicle were checked. The presence of cholesteatoma was also checked. Otolaryngology: Open Access Haidar, et al, Otolaryngol (Sunnyvale) 2015, 5:4 http://dx.doi.org/10.4172/2161-119X.1000203 Research Article Open Access Otolaryngol (Sunnyvale) ISSN:2161-119X Otolaryngology, an open access journal Volume 5 • Issue 4 • 1000203