A Prospective Study of Status of Contralateral Ear in Unilateral Chronic Otitis Media-Based on Otoendoscopy, Audiological, and Radiological Investigations.

Background Chronic otitis media is classically defined as an irreversible inflammation of mucoperiosteal lining of the middle ear cleft, entirely or in parts. The pathological factors that cause otitis media in one ear may also cause it in the other since both ears share the aeration and drainage. The fact that persistent otitis media can develop into chronic otitis media (COM) is another unresolved issue. This study was carried out to evaluate the anatomical and functional alterations of the contralateral ear in patients with unilateral chronic otitis media. Objectives The objectives of this study were to identify the anatomical findings of contralateral ear in patients with unilateral chronic otitis media with otoscopy and X-ray mastoids/HRCT Temporal bone and to find out the functional findings of contralateral ear with pure tone audiometry, tympanometry and Eustachian tube function. Methods A prospective observational study was conducted over a period of ten months from September 2022 to June 2023 among 90 patients with unilateral ear chronic otitis media attending the ENT OPD of Sri MuthuKumaran Medical College and Research Institute, Chennai. Patients above 18 years of age with chronic otitis media in one ear, irrespective of gender and those who gave informed consent were included in the study. The history and clinical examination were recorded. Otoscopy, pure tone audiometry, tympanometry, X-ray mastoids/HRCT Temporal bone and Eustachian tube function testing were done for all the patients. The data was entered in MS Excel and was analyzed using SPSS version 24. Descriptive statistics and inferential statistics such as Chi square test were used. P value < 0.05 was considered significant. Results The mean age of the study participants was 39.73 ± 14.64 years. Majority of participants (n=26) were in 31 to 40 years age group. Majority of the participants (n= 57, 63.3%) were females and 33 participants (36.7%) were males. Among the findings of unilateral ear, 69 participants (76.7%) had mucosal type and 21 participants (23.3%) had squamous type of COM. Regarding tympanic membrane findings in contralateral ear, in mucosal type, 21 participants had retracted tympanic membrane and in squamous type, 16 participants had retracted tympanic membrane which was statistically significant. In mucosal type, 63.8% had dysfunction in Eustachian tube and in squamous type 9.5% had dysfunction in Eustachian tube which was statistically significant by Chi square test. Conclusion The findings of this study indicate that diverse variations were observed in the contralateral ear of the patients with unilateral chronic otitis media so it should not be thought of as a condition that only affects one ear because it frequently affects both ears. Therefore, in patients with unilateral COM, this study shows the importance of continuous monitoring of the contralateral ear in order to diagnose any changes and, if necessary, give prompt therapeutic intervention. These observations can substantially aid in adding information in understanding the disease evolution in chronic otitis media. [ABSTRACT FROM AUTHOR]