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<p>Active squamous chronic otitis media (COM) is characterized by retraction of the pars flaccida or pars tensa with accumulation of keratinized squamous epithelium, frequently accompanied by persistent inflammation and purulent discharge. Hearing loss in such cases usually results from ossicular erosion caused by cholesteatoma, which disrupts the continuity of the ossicular chain. Preoperative estimation of ossicular discontinuity is often based on the extent of disease spread and audiometric results. However, some studies suggest that pure tone audiometry (PTA) may not reliably predict ossicular necrosis before surgery. This study was conducted to assess the accuracy of preoperative audiometric findings in predicting intraoperative ossicular chain status. A prospective cross-sectional analysis was performed on 30 patients diagnosed with active squamous COM who underwent tympano-mastoidectomy. Preoperative audiometric parameters were compared with intraoperative findings of ossicular integrity. The incus was the most frequently affected ossicle, followed by the malleus and the stapes superstructure. Among all audiometric parameters, an air–bone gap (ABG) of &gt; 30 dB at 500&#xa0;Hz was the most reliable predictor of ossicular discontinuity, with 86.1% accuracy. A significant association was observed between ossicular status and ABG values, particularly for the incus, which showed the strongest correlation with average ABG. While PTA provides valuable information about the degree of conductive hearing impairment, it cannot be considered a standalone tool for predicting ossicular necrosis. Intraoperative examination remains the definitive method for confirming ossicular chain integrity.</p>

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Correlation of Pre-operative Audiometric Profile with Intra-operative Ossicular Chain Status in Active Squamous Chronic Otitis Media

  • 期刊论文

  • 发表日期：

    2026年2月7日

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  • Vibha Singh,
  • Himani Lade,
  • Pragya Singh

摘要

Active squamous chronic otitis media (COM) is characterized by retraction of the pars flaccida or pars tensa with accumulation of keratinized squamous epithelium, frequently accompanied by persistent inflammation and purulent discharge. Hearing loss in such cases usually results from ossicular erosion caused by cholesteatoma, which disrupts the continuity of the ossicular chain. Preoperative estimation of ossicular discontinuity is often based on the extent of disease spread and audiometric results. However, some studies suggest that pure tone audiometry (PTA) may not reliably predict ossicular necrosis before surgery. This study was conducted to assess the accuracy of preoperative audiometric findings in predicting intraoperative ossicular chain status. A prospective cross-sectional analysis was performed on 30 patients diagnosed with active squamous COM who underwent tympano-mastoidectomy. Preoperative audiometric parameters were compared with intraoperative findings of ossicular integrity. The incus was the most frequently affected ossicle, followed by the malleus and the stapes superstructure. Among all audiometric parameters, an air–bone gap (ABG) of > 30 dB at 500 Hz was the most reliable predictor of ossicular discontinuity, with 86.1% accuracy. A significant association was observed between ossicular status and ABG values, particularly for the incus, which showed the strongest correlation with average ABG. While PTA provides valuable information about the degree of conductive hearing impairment, it cannot be considered a standalone tool for predicting ossicular necrosis. Intraoperative examination remains the definitive method for confirming ossicular chain integrity.