Morphometric Comparison of Tympanic Membrane in Unilateral Mucosal Chronic Otitis Media

Previous studies of the middle ear in Chronic Otitis Media have focussed on radiological assessment of temporal bone; endoscopic studies were focussed on perforation size and location. The malleus handle (manubrium) is a constant ossicular feature visible on otoendoscopy. It’s relative position may indicate the previously documented differences in ossicular chain and middle ear cleft development relative to the tympanic ring and inner ear capsule between affected ear and contralateral ear. Design: descriptive. Setting: hospital based. Subjects: 84 patients with unilateral mucosal chronic otitis media. Methods: each patient underwent Otoendoscopy and the findings were recorded through a camera connected to a laptop. Using image j software these images were analysed. Participants were of mean age of 35 years with left preponderance, and no gender preponderance was found. In our study, majority of the perforations were small sized perforations. The malleus handle foreshortening was about 92.6% compared to unaffected ear which was statistically insignificant. There was a significant inter group difference in the distance between the tip of the manubrium and the inferior annulus—which was decreased in affected ears and in the distance from the lateral process to the anterior tympanic ring—which was increased in affected ears. There was no difference in the malleo scutal angles. These differences were not dependent on the site or size of the perforation. The differences we found between ears were unexpected. The significance of the differences in the shape of the tympanic membrane between affected and unaffected ears in unilateral mucosal COM need further study. We did not find a statistically significant difference in the malleo-scutal angles between ears.