Evaluation of the contralateral ear in cases of unilateral chronic otitis media: a cross sectional observational study
Authors: Khan Yasir Abbas , Kanotra Sonika , Zehra Mehvish , Anjum Areena , Sharma Preeti , Majeed Farkhanda 
Published: December 2024

Abstract
Aims and objectives
To study the clinical status of contralateral ear in cases of unilateral CSOM.

Introduction
In the medical field, understanding the clinical status of the contralateral ear in cases of unilateral Chronic Suppurative Otitis Media (CSOM) is crucial for effective treatment. This study was conducted at Shri Maharaja Ghulab Singh Hospital in Jammu, India from November 2020 to October 2021, involving 105 patients who met the inclusion criteria.

Materials and methods
A thorough examination was carried out, including taking a detailed history of symptoms such as hearing loss, discharge, vertigo, tinnitus, and pain. An ENT examination was conducted, assessing the pinna, external auditory canal, tympanic membrane, and ossicles. Otoendoscopic examination of the ear and diagnostic nasal endoscopy were also performed to rule out any nasal pathology.

Results
Out of 105 patients in our study, 61 were females and 44 were males.

The main presenting symptoms were ear discharge alone in 84 patients followed by associated hearing impairment in 15, and 6 patients had tinnitus. Among 105 patients, the duration of ear discharge from > 5 years was seen in 36 patients, followed by 1–2 years in 29 patients, 2–5 years in 22 patients, and from < 1 year in 18 patients. Ninety-five patients were diagnosed to have mucosal COM and 10 had active squamosal disease. Thirty-four patients had subtotal perforation of pars tensa in the ipsilateral diseased, 26 patients had medium-sized perforation, 18 patients had small-sized perforations, 12 had large perforation, 10 had attic perforation, and 5 had total perforation. Thirty-four patients had a normal tympanic membrane of the contralateral ear and abnormalities of contralateral tympanic membrane were seen in 71 patients. Eighty-eight patients had deviated nasal septum on DNE. Among 105 patients, PTA assessment showed that 103 patients had a conductive hearing loss in the diseased ipsilateral ear. B type tympanogram was found in 70 diseased ears and the contralateral ear of those patients showed A type tympanogram in 20 and B-type tympanogram in 50 ears. C type tympanogram was seen in 35 diseased ears and the contralateral ear of those patients showed A type tympanogram in 12 patients and C type tympanogram in 23 patients. Contralateral mastoid X-ray showed well pneumatization in 45 patients followed by diploic type of pneumatization in 55 patients and sclerotic mastoid in 5 patients.

Conclusion
The findings of this study emphasize the importance of considering both ears in the treatment of CSOM. It is crucial to educate patients about the potential bilateral effects of the disease for proper therapy planning. This study sheds light on the significance of examining the contralateral ear in patients with unilateral CSOM. Understanding the clinical status of both ears can lead to more comprehensive treatment strategies and better outcomes for patients.