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A comparative study of middle ear evaluation by otomicroscopy and otoendoscopy in cases of chronic suppurative otitis media

Arjun Gopinatha Menon, Maitri Kaushik, Varghese Nevil, Arayamparambil Rajagopalan Vinayakumar.


Purpose: Chronic suppurative otitis media (CSOM) is one of the common causes for hearing impairment and disability. Despite continuous technical improvements, the basic optical principles and their limitations have remained the same over the past three decades. This study was aimed at visualizing and evaluating the middle ear structures with the aid of an otomicroscope and 0, 30 and 70 degree-angled endoscopes in cases of chronic suppurative otitis media.
Methods: In this prospective study, 100 patients (63 males and 37 females) above the age of 10 years with CSOM were subjected to both otomicroscopy and otoendoscopy. The visualizations of middle ear structures were compared and statistically analyzed.
Results: Middle ear structures were better evaluated with 30 and 70 degree endoscopes (p < 0.05) than with a microscope. No statistically significant (p > 0.05) advantage of endoscopes over microscopes was detected in examining middle ear mucosa. However, the microscope was better than a 70 degree endoscope in visualization of the mouth of the retraction pocket.
Conclusion: Endoscopy provided a significantly better visualization for all the parameters studied versus a microscope. It is desirable to study the role of the endoscope in more cases of unsafe CSOM and also intraoperatively.

Key words: Otoendoscopy; otomicroscopy; suppurative otitis media; middle ear; middle ear disease

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