Clinical landmarks in chronic otitis media with tympanosclerosis: clinical history may have predictive value in the diagnosis of ossicular chain mobility.

OBJECTIVES: To evaluate clinical characteristics of tympanosclerosis and to investigate the predictive value of clinical evaluation in diagnosing the ossicular chain status in tympanosclerosis. METHODS: The study included 166 ears operated on for chronic otitis media. Age, gender, duration of symptoms and history of ear drainage were recorded from the patient's file. Details of ossicular mobility were obtained from the operation records. RESULTS: There was no difference in age or disease duration between ears with chronic otitis media with or without tympanosclerosis. The ears with chronic otitis media without tympanosclerosis had a higher rate of middle-ear suppuration compared to those with tympanosclerosis (p < 0.001). In chronic otitis media with tympanosclerosis, the ears with a mobile ossicular chain had a higher rate of active drainage in their clinical history compared to ears with a fixed ossicular chain (p = 0.026). Stapes fixation was present mostly in dry ears with tympanosclerosis (p = 0.005). CONCLUSION: Chronic otitis media with tympanosclerosis is characterised by the long-term absence of suppurations. The probability of having a fixed ossicular chain or stapes was higher in tympanosclerosis cases with no ear drainage.

The role of the nasal and paranasal sinus pathologies on the development of chronic otitis media and its subtypes: A computed tomography study.

OBJECTIVE: This objective of this study is to evaluate the presence and the coincidence of common nasal and paranasal sinus pathologies in adults suffering from chronic otitis media (COM) and its subtypes. MATERIALS AND METHODS: The study group comprised 354 ears of 177 patients who underwent tympanoplasty with or without mastoidectomy from January 2013 to February 2015 due to uni/bilateral COM. Chronic suppurative otitis media, intratympanic tympanosclerosis (ITTS), cholesteatoma, and tympanic membrane with retraction pockets constituted subtypes of COM. The control group consisted of 100 ears of 50 adult patients with aural diseases other than middle ear problems. All patients were evaluated for the evidence of mucosal disease on paranasal sinuses, the presence of concha bullosa (CB), and the angle of nasal septal deviation (NSD) and thickness of the medial mucosa of the inferior turbinate were measured by coronal computed tomography images. RESULTS: The incidence and the angle of NSD were found significantly higher in patients with COM (P = 0.028, P = 0.018; respectively). When ears with unilateral and bilateral COM compared in term of sinonasal pathologies, CB was found higher in patients with unilateral COM (P = 0.040). The presence of CB was significantly higher in ITTS when compared to other subtypes (P = 0.028). CONCLUSIONS: Our study suggests that obstructive nasal pathologies such as NSD and CB may play a role in the pathogenesis of especially unilateral COM. However, there was no correlation between COM and inflammatory pathologies such as sinusitis.

Relationship between tumour-node-metastasis stage of laryngeal squamous cell carcinoma and duration of symptoms.

OBJECTIVE: To evaluate the relationship between disease stage and duration of symptoms for squamous cell carcinoma of the larynx. METHOD: We evaluated retrospectively data from 102 laryngeal squamous cell carcinoma patients seen in the otorhinolaryngology department of the Gazi University School of Medicine between December 1996 and June 2004. Inclusion criteria were a histologic diagnosis of laryngeal squamous cell carcinoma, no previous medical, surgical or radiological treatment for carcinoma, and the absence of any other primary tumours or distant metastatic disease. RESULTS: There was no relationship between duration of symptoms and stage of the disease, both for glottic and supraglottic tumours. When glottic and supraglottic tumours were compared, no significant difference in symptom duration could be found. CONCLUSION: There is no correlation between symptom duration and the stage of the disease for squamous cell carcinoma of the larynx. Therefore, symptom duration does not reflect the stage of the tumour.