CSOM; ossicular damage in atticoantral variant

The current study aims to find the extent of ossicular chain damage in patients with chronic suppurative otitis media, associated with cholesteotoma and/or granulation tissue formation. Descriptive study. The study was conducted at the department of ENT unit 1, Jinnah hospital/ Allama Iqbal Medical College Lahore from March, 2007 to March, 2008. A total of fifty consecutive patients presenting with atticoantral disease of different age groups were included in the study. All patients were examined clinically and under microscope. X- rays mastoids and pure tone audiometry was done in all patients. Mastoid exploration was done in all the patients and ossicullar status was assessed peroperatively. Canal wall down procedure was adopted in all the patients. Among different age groups included, majority [more than 70%] of them, were below 30 years of age, showing that atticoantral variant of CSOM is a disease of the young people. Males were more in number [70%]. Duration of the symptoms was usually prolonged. On radiological examination, 39 cases [78%] had sclerotic mastoid. Audiological records of patients showed the air bone gap of more than 40 dB in most of [78%] of patients. Perforation was marginal in most of the patients [64%]. In gross pathologic findings, cholesteotoma only, was seen in 21 cases [42%], granulations seen in 13[26%] cases, while cholesteotoma and granulations seen in 16 cases [32%]. All cases showed erosion of the ossicles, complete or partial. Incus was a most commonly involved ossicle. Chronic suppurative otitis media, atticoantral variant do commonly damage the ossicles and routinely it is multiossicular damage. Incus, is damaged most with involvement of its long process

Disgenesias de la cadena osicular: (Síndrome de disco) / Dysgenesis of the osicular chain: (discïs syndrome)

En este trabajo la atención sobre un capítulo muy especial de la otología. En algunas obras está mencionada esta patología muy someramente, algunas veces mal incluida en el capítulo de las atresias del conducto auditivo externo, y en varios libros clásicos, ni siquiera se menciona. El tema se refiere a las anomalias congénitas enteramente limitadas a la cadena osicular y sus sistema propio muscular, diferenciándolas de las anomalías de mayor grado que abarca la aurícula y el conducto auditivo externo. El autor introduce una nueva nomenclatura, para identificar este tipo de disgenesias, limitadas a los huesecillos del oído medio. Presenta una serie de 17 casos detectados personalmente, y hace una descripción concreta de los hallazgos quirúrgicos encontrados y expone los resultados de la reconstrucción de la función auditiva que ha realizado en 15 casos de esta serie. Adivierte la importancia de tener presente este peculiar tipo de patología en los casos de hipoacusias conductivas, para considerarla al establecer el diagnóstico diferencial, especialmente en niños y adultos jóvenes. Asismismo invita al otocirujano moderno a familiarizarse con estos casos, y desarrollar una gran imaginación reconstructiva, para lograr la habilitación de la audición en estos pacientes. Finalmente propone una clasificación general de las diversas modalidades que se pueden observar en estas disgenesias, en base a una revisión bibliográfica sobre la materia y su experiencia personal

Congenital anscmalies of the auditory ossicles and the oval ainthdocui the utllal formation of the external ear

Out of 400 specimens of temporal bones, the author found one case of congenital anomaly of the auditory ossicles and the oval window without malformations of the external ear, i.e. 0.25%. This case is believed to represent the first case of anomaly involving the superior and inferior parts of the ossicular chain which have different origins