Zafar Iqbal Gill, Kashif Iqbal Malik, Zubair Iqbal Bhutta.
Ossicular damage in atticoantral variant.
Professional Med J Jan ;16(3):414-8.

Objective: 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. Design: Descriptive study. Place and Duration of 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. Patients and Methods: 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. Results: 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. Conclusion: 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.

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