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Diagnostic Performance of Endoscopic and Microscopic Procedures for Identifying
Different Middle Ear Structures and Remaining Disease in Patients with Chronic
Otitis Media: A Prospective Cohort Study
#MMPMID26167935
Farahani F
; Shariatpanahi E
; Jahanshahi J
; Poorolajal J
PLoS One
2015[]; 10
(7
): e0132890
PMID26167935
show ga
BACKGROUND: The diagnostic performance of endoscopic and microscopic procedures
for detecting diseases of the middle ear in patients with chronic otitis media
(COM) has rarely been investigated. This study was conducted to compare the
performance of these procedures for identifying middle ear structures and their
associated diseases in COM patients. METHODS: In this prospective cohort study,
58 patients with chronic COM, who were candidates for tympanoplasty with or
without a mastoidectomy, were enrolled. Before the surgical intervention, the
middle ear was examined via an operating microscope and then through an endoscope
to identify the middle ear structures as well as diseases associated with the
middle ear. RESULTS: The patients were 15 years of age or older. The anatomical
parts of the middle ear - the epitympanic, posterior mesotympanic, and
hypotympanic structures - were more visible through an endoscope than through a
microscope. In addition, the various segments of the mesotympanum, oval window,
round window, and Eustachian tube were more visible via endoscopy. The
post-operative endoscopic reevaluation of the middle ear revealed that a
cholesteatoma had remained in four of 13 patients after surgery. CONCLUSION:
According to the results of this study, in cases in which there is poor
visibility with the operating microscope or the surgeon suspects remaining
disease within the middle ear, endoscopy could be utilized to improve the
evaluation of more hidden middle ear pits and structures, particularly if there
is a potentially recrudescent pathology.
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