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Otoendoscopy as a better preoperative predictor than pure tone audiometry for ossicular erosion in mucosal chronic otitis media

Published online by Cambridge University Press:  01 May 2024

Abhishek Bhardwaj Open the ORCID record for Abhishek Bhardwaj [Opens in a new window] ,
Kartikesh Gupta ,
Suji PS Open the ORCID record for Suji PS [Opens in a new window] ,
Manu Malhotra ,
Madhu Priya ,
Saurabh Varshney ,
Rachit Sood  and
Arpana Singh
Abhishek Bhardwaj
Affiliation:
Department of Otorhinolaryngology & Head-Neck Surgery, All India Institute of Medical Sciences, Rishikesh, India
Kartikesh Gupta
Affiliation:
Department of Otorhinolaryngology & Head-Neck Surgery, All India Institute of Medical Sciences, Rishikesh, India
Suji PS
Affiliation:
Department of Otorhinolaryngology & Head-Neck Surgery, All India Institute of Medical Sciences, Rishikesh, India
Manu Malhotra*
Affiliation:
Department of Otorhinolaryngology & Head-Neck Surgery, All India Institute of Medical Sciences, Rishikesh, India
Madhu Priya
Affiliation:
Department of Otorhinolaryngology & Head-Neck Surgery, All India Institute of Medical Sciences, Rishikesh, India
Saurabh Varshney
Affiliation:
All India Institute of Medical Sciences, Deoghar, Jharkhand, India
Rachit Sood
Affiliation:
Department of Otorhinolaryngology & Head-Neck Surgery, All India Institute of Medical Sciences, Rishikesh, India
Arpana Singh
Affiliation:
Department of Microbiology, All India Institute of Medical Sciences, Rishikesh, India
*
Corresponding author: Manu Malhotra; Email: [email protected]
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Abstract

Objective

To compare the diagnostic accuracy of angled otoendoscopy with pure tone audiometry in predicting ossicular discontinuity in patients of mucosal chronic otitis media.

Methods

Ninety-four patients were included in this prospective study. A 2.7-mm 30° otoendoscope was used to examine ossicular status preoperatively. Hearing thresholds were recorded by pure tone audiometry. Intraoperative ossicular status was recorded as the gold standard. Otoendoscopic findings were recorded as per the criteria has been devised by the authors of this manuscript.

Results

Otoendoscopy was conclusive in 56 (59.6 per cent) patients, with 100 per cent sensitivity, 95.56 per cent specificity, 84.62 per cent positive predictive value, and 100 per cent negative predictive value in the conclusive group. Overall (in 94 patients), diagnostic test values of otoendoscopy were 73.33 per cent sensitivity, 97.47 per cent specificity, 84.62 per cent positive predictive value, and 95.06 per cent negative predictive value. As per the ROC curve, air–bone gap > 38.12dB had the optimal diagnostic test values, with 73 per cent sensitivity, 72 per cent specificity, 33.3 per cent positive predictive value, and 93.4 per cent negative predictive value.

Conclusion

Angled otoendoscopy has better diagnostic accuracy (93.6 per cent) than pure tone audiometry (72.3 per cent; p < 0.001) for preoperative ossicular discontinuity prediction in patients of mucosal chronic otitis media.

Keywords

endoscopyaudiologyhearing lossdiagnosisotitis media
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 138 , Issue 10 , October 2024 , pp. 1013 - 1017
Copyright
Copyright © The Author(s), 2024. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Manu Malhotra takes responsibility for the integrity of the content of the paper

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