Bone mineral density of the incus body and long process in patients with chronic otitis media and its relationship with functional outcome in type II tympanoplasty

Abstract

Background

Inflammatory conditions such as chronic otitis media (COM) can cause irreversible impairments in the microarchitecture and functions of the incus, which subsequently leads to conductive hearing loss.

Objectives

To investigate bone mineral density (BMD) of the incus body (IB) and long process (ILP) on preoperative temporal CT in COM patients with and without incudo-stapedial joint discontinuity (ISJD), and also to determine the association between BMD values and the postoperative air-bone gap (ABG) in the ISJD group.

Material and methods

The mean IB density (IBD)/occipital bone density (OBD) and ILP density (ILPD)/OBD values were compared between the patients with and without ISJD. The correlation between ABG gain and preoperative incus density values was assessed in the ISJD group.

Results

The mean IBD/OBD and ILPD/OBD values were significantly higher in patients with intact ISJ. There was a moderate positive correlation between postoperative ABG gain and ILPD/OBD values in the ISJD group.

Conclusion and significance

The decrease in BMD of the incus may involve ILP as well as IB in patients with ISJD caused by ILP lysis in COM. A higher preoperative ILPD/OBD was correlated with a higher postoperative ABG gain in COM patients with ISJD.

Chinese Abstract

背景

慢性中耳炎 (COM) 等炎症性疾病可能会导致砧骨微结构和功能的不可逆转的损害, 随后导致传导性听力损失。

目的

通过有或无砧骨-镫骨关节间断 (ISJD) 的 COM 患者的术前颞部 CT, 研究砧骨体 (IB) 和长突 (ILP) 的骨矿物质密度 (BMD), 并确定ISJD 组群中 BMD 值与术后气骨间隙 (ABG) 之间的相关性。

材料和方法

比较有和无 ISJD 患者之间的平均IB密度(IBD)/枕骨密度(OBD)和ILP密度(ILPD)/ OBD 的值。 评估 ISJD 组中ABG 增益和术前砧骨密度值之间的相关性。

结果

ISJ 完整的患者的平均 IBD/OBD 和 ILPD/OBD 值显著较高。ISJD 群组中, 术后 ABG 增益与 ILPD/OBD 值呈中度正相关。

结论及意义

ISJD患者的砧骨BMD下降可能与ILP和IB有关, 是由 COM 中 ILP 裂解引起的。 对于患有 ISJD 的 COM 患者, 术前较高的 ILPD/OBD值与术后较高的ABG 增益相关。

Keywords:

• Chronic otitis media
• incus
• ossiculoplasty
• bone cements
• multislice computed tomography
• bone mineral density

Disclosure statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.