Volume 03 Issue 10-2023
61
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
10
P
AGES
:
61-64
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
ABSTRACT
To review the effectiveness of high-resolution computed tomography in making a diagnosis of tympanosclerosis and
its reliability in predicting the postoperative period based on the result of hearing restoration, also based on
radiological and surgical data. Methods: A retrospective survey was conducted in diagnostic and treatment
institutions, and tympanoplasty was performed for chronic suppurative otitis media (CSOM) 200 ear. In March 2020
and 2021 of the same month, preoperative MSCT images of the temporal bone were reviewed, to verify the prognosis
of tympanosclerosis and the integrity of the auditory ossicles. The integrity of the ossicular chain was checked both
preoperatively and postoperatively using audiometry (air-bone conduction (ABG)) and the results were assessed:
postoperative successful outcome was a tone frequency and sound volume level of 20 dB or less. Results: The study
was conducted on 200 ears that underwent tympanoplasty for CSOM, of which 130 out of 200 (49%) ears had
tympanosclerosis localized in the eardrum, discovered during surgery (tympanoplasty), ears were affected in 41 out
of 130 (30, 1%), Incus-malleus ossicular ligament disorders occurred in 19 of 41 ears. 11 ears with a disorder of the stapes
bone, and 6 with a disorder of the connection of all three bones. In the remaining 70 cases, a scan of the temporal
bone revealed the integrity of all hearing bones and their conductivity. After 6 months, during repeated observation
of patients, audiological results of fixation with sensitivity were obtained
Research Article
THE ROLE OF HIGH-RESOLUTION MSCT IN THE DIAGNOSIS OF
OSSICULAR CHAIN DISORDER TYMPANOSCLEROSIS
Submission Date:
October 17, 2023,
Accepted Date:
October 22, 2023,
Published Date:
October 27, 2023
Crossref doi:
https://doi.org/10.37547/ijmscr/Volume03Issue10-11
Kakharov A.J.
Researcher Tashkent State Dental Institute, Uzbekistan
Zokirova Z.J.
Researcher Tashkent Medical Academy, Uzbekistan
Journal
Website:
https://theusajournals.
com/index.php/ijmscr
Copyright:
Original
content from this work
may be used under the
terms of the creative
commons
attributes
4.0 licence.
Volume 03 Issue 10-2023
62
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
10
P
AGES
:
61-64
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
(95.1%) and specificity (93.8%). Conclusions: Based on the conducted research, it is possible to draw the following
conclusion: for otolaryngologists, MSCT in combination with clinical data serves to effectively assess the extent of the
lesion, as well as inform for the postoperative prognosis for tympanosclerosis.
KEYWORDS
Chronic suppurative otitis media, MSCT of the middle ear, reconstruction of the auditory ossicular chain,
tympanoplasty, tympanosclerosis.
INTRODUCTION
Chronic suppurative otitis media (CSOM) is one of the
most common recurrent infections of the middle ear or
mastoid process (mastoiditis) and is an inflamed
process of the mucous membrane of the middle ear
and is characterized by the presence of persistent
perforation of the eardrum [1,4] . CSOM is considered
one of the leading causes of conductive hearing loss in
adults, which is secondary to damage to the eardrum
and middle ear ossicles [4].
Tympanosclerosis is accompanied by the deposition of
hyalinized collagen in tympanic cavity. On the middle
ear cavity or on the tympanic membrane, this picture
looks like unifocal or multifocal punctate or arachnoid
calcifications [3]. On CT of the tympanic cavity, the
localization is not definite and is presented as focal
calcified compactions in the middle ear cavity along
with the tendons opposite the chain of auditory
ossicles [5,7]. It is found in 10%-40% case of CSOM
sufferers [3].
In most cases with Tympanosclerosis, the lesions are
localized in the eardrum (50%). In 30% of cases, the
ligaments of the auditory ossicles, interosseous joints,
muscle tendons and submucosa are destroyed. In 20%
of cases with tympanosclerosis, a mixed type of
damage is observed to both the eardrum and the
structures of the middle ear. Intratympanic CT leads to
hearing loss since it mainly affects the small structure
of the middle ear, involving 35-45% of the auditory
ossicles.
The operations performed to restore the eardrum and
restore the auditory ossicles are concentrated on
eliminating the disease and restoring hearing [6].
For otolaryngologists, CT scanning in combination with
clinical data serves to effectively assess the extent of
the lesion, as well as informative for the postoperative
prognosis for tympanosclerosis on computed
tomography: ossified or calcified areas with high
density soft tissue in the middle ear cavity, resulting in
ovoid, linear or
Volume 03 Issue 10-2023
63
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
10
P
AGES
:
61-64
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
web form and this provides information about the
condition of the chain of auditory ossicles and, of
course, directly determines the further course and
prognosis of ear surgery [7,9,10].
The study was conducted to evaluate the potential
value of HRCT in OCF prediction in CSOM. The results
of this study can serve as a way for patients to obtain
accessible information about downtime activities and
accordingly discuss possible issues that may arise
before surgery. The main purpose of this study was to
determine the reliability High-resolution CT (HRCT) in
diagnostics tympanosclerosis based on comparison of
radiological and surgical findings [3,7].
Results. The study included 130 patients (200 ears) with
CSOM who underwent tympanoplasty of one or both
ears. The average age range was from 5 to 50 years
with a male-to-female ratio of 1.7. Of the 200 ears with
CSOM (98/200), 49% had tympanosclerosis during
revision of the middle ear during tympanoplasty.
Tympanosclerosis
located
on
the
eardrum
(myringosclerosis) in 57 of 98, 58.2% of affected ears.
Tympanosclerosis with damage to the auditory ossicles
was 41 out of 98, 41.8%. With impaired fixation of the
auditory
ossicles
(Ossicular
tympanosclerosis)
distributed as follows:
19 out of 41 (46.3)% with incus-malleus fixation, 11
(26.8%) with stapes.
With violation of triple fixation 6 (14.7%).
X-ray data and clinical and radiological indicators
Of 200 ears, preoperative CT revealed cases with
disruption of the ossicular chain in 69 (34.5%), 48 with
incus-malleus fixation, 17 with stapes fixation, and 4
with complete osseous fixation.
Preoperative X-ray picture with suspicion of
tympanosclerosis with impaired fixation of the
auditory ossicles was in the 64 ears were distributed as
36 of 56 ears with suspected incus-malleus fixation, 14
of 19 with stapes fixation, and 3 of 4 with triple fixation.
The overall conclusion from the study is that CT is an
invaluable information method in the preoperative
diagnosis of the integrity of the auditory ossicular
chain.
CONCLUSION
Our study once again shows that CT of the temporal
bone remains one of the important methods in making
the correct diagnosis, as well as predicting the
postoperative outcome. With all this, CT in
combination with clinical data will serve in diagnose
the etiology of hearing loss and identify the localization
tympanosclerosis, in patients with chronic otitis media
and conductive hearing loss and in preoperative
assessment for otolaryngologists.
Volume 03 Issue 10-2023
64
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
10
P
AGES
:
61-64
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
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