Preoperative Predictors in Chronic Suppurative Otitis Media for Ossicular Chain Discontinuity: A Cross-Sectional Study

Objective: Ossicular discontinuity may result from chronic suppurative otitis media and is usually detected intraoperatively. Our objective is to determine whether a preoperative audiogram can preoperatively predict the presence or absence of ossicular discontinuity. Methods: A cross-sectional study was prospectively run on our patients, aged 12-75 years, ultimately operated on for chronic suppurative otitis media. Preoperative audiograms were analyzed to measure frequency-specific air-bone gap (ABG) cutoff values. Intraoperatively, ossicular chain integrity was carefully checked. Logistic regression analysis was done to obtain a predictive model. Results: A total of 270 patients (306 ears) were included. Frequency-specific ABG cutoff values can predict ossicular discontinuity, namely: high ABGs at 1,000 Hz (>27.5 dB) and 2,000 Hz (>17.5 dB) are the most reliable variables associated with ossicular discontinuity. Conclusion: Preoperative audiograms can predict the presence of ossicular discontinuity in chronic suppurative otitis media. Large ABGs at both 1,000 and 2,000 Hz can predict ossicular discontinuity with a great degree of certainty.