Background: There is some evidence supporting mobilizing fixed ossicles, but there are concerns regarding re-fixation and recurrence of conductive hearing loss. Disagreements about the pathophysiologic process and illusive hearing results after the treatment lead to controversies about the management of this disease. Overall, surgeons adopt one of the following strategies for hearing loss in TYMPANOSCLEROSIS: (1) no manipulation of risky sites and use of amplification instead, (2) mobilization, or (3) stapedectomy. Methods: This study is a retrospective analysis of clinical records, operative notes and audiologic data of patients (1992-2009). Audiometric findings are reported according to the recommendations of the Committee on Hearing and Equilibrium 1995 Guidelines for the Evaluation of Results of Treatment of Conductive Hearing Loss.Results: The mean follow-up period was 28.27 months (0-170). The air conduction threshold was significantly decreased after the surgery (49.3 to 40.4 dB). Sixty-two ears (31.6%) achieved none of the above criteria and were considered poor postoperative results. The hearing results were significantly worse in patients with ossicular involvement. At the first stage, we do not attempt to mobilize the fixed stapes, and we do our best to prepare a mobile incudo-malleus complex for the second stage. The pure tone average was significantly improved in patients with incudomallal fixation, stapes fixation, or total ossicular fixation. The surgery was considered successful in 65.3% of IM fixed patients, 100% of pure stapes fixed patients, and 62.7% of all in the ossicular fixation group. Interestingly, 41.2% of the patients had their bone conduction level improved after the surgery; however, in 11.3% of the patients, a bone conduction decrease of more than 10 dB occurred.Conclusion: Surgery is a safe and efficacious method of treatment for TYMPANOSCLEROSIS, which not only can eliminate otorrhea, and life limiting consequences of this disease, but also can significantly improve hearing. If, after the surgery, no hearing improvement is achieved, at least hearing aids can be used with an intact tympanic membrane.

Background: TYMPANOSCLEROSIS is a condition caused by calcification of tissues in the middle ear mucosa that sometimes results hearing loss. Helicobacter pylori is one of the pathological and etiologic factors in the development of TYMPANOSCLEROSIS.Objectives: The purpose of this study was to show the role of H. pylori in the different aspects of chronic suppurative otitis media using the polymerase chain reaction (PCR) technique.Patients and Methods: This case-control and cross-sectional study was performed on all patients with chronic otitis media, candidates for surgical operations, in 2013. They were allocated into the case group with TYMPANOSCLEROSIS and the control group without TYMPANOSCLEROSIS. During the surgical operation, biopsy was done from middle ear and the samples were studied to see if they contained H. pylori using the PCR method.Results: From a total of 19 patients with TYMPANOSCLEROSIS , 16 cases (84.2%) were H. pylori positive, while in the control group 15 (45.4%) cases out of the 37 cases were H. pylori positive, which showed a significant difference (P=0.002). Age and gender of the patients, ear dryness and perforation size were not correlated with the presence or absence of H. pylori.Conclusions: There is a significant correlation between TYMPANOSCLEROSIS and H. pylori (P=0.002). This correlation can single out H. pylori as a pathological factor in the development of TYMPANOSCLEROSIS; however, further studies are needed to prove this correlation.

Background: TYMPANOSCLEROSIS is one of complications of chronic otitis media with accumulation of hyaline and calcified deposits intra tympanic membrane and middle ear's membrane. In most cases these plaques are of minimal clinical significance and result in trivial hearing dysfunction. Methods: 60 patients diagnosed with chronic otitis media and TYMPANOSCLEROSIS who were candidates for operation and met inclusion criteria were evaluated. Audiometric evaluations were assessed before and after surgery. Intra operative findings and Post operative clinical results were also evaluated after surgery. Results: 25(43. 1%) patients were male and 33(56. 9%) were female. Hearing dysfunction was monolateral in 62. 1% and bilateral in 37. 9%. The most common location of ossicular chain fixation is between incus and malleus reported in 24(41. 3%) patients. Conclusion: Middle ear surgery result is astonishing although other factors such as severity of sclerosis and fixation localization may also be influential in surgical results.

Background & Objectives: Hearing is perhaps the most important sense in human beings without which communication with the environment would greatly diminish. Chronic perforation of tympanic membrane, ossicular erosion and TYMPANOSCLEROSIS are major causes of hearing disorders. Nevertheless, a conducting hearing loss is the commonest complication of chronic otitis media. Cholesteatoma which is the most dangerous complication of chronic otitis media is treated by surgery. TYMPANOSCLEROSIS is also one of the most important complications of chronic otitis media, which leads to conductive hearing loss through ossicular fixation. This study is an attempt to determine the effect of different kinds of  chronic otitis media on the hearing of the patients. Methods: In this survey, 440 patients with chronic otitis media, who were surgical1y treated in the department of otolaryngology between 1998-1999, were studied in terms of various pathology of middle ear and the resultant level of hearing impairment. Results: 37 patients (8.4%) were involved bilaterally with otitis media. The number of operations on the left ear was 10% more than those on the right. The most common pathology recognized in examination was nonprulant perforation of tympanic membrane in 179 cases (40.7%) and the most common pathology recognized in surgery was cholesteatoma in 140 cases (30.2%). From 440 patients, 430 cases had conductive hearing loss and 92 cases (20.9%) had sensorineural hearing loss. Cholesteatoma of middle ear caused the highest proportion of conductive hearing loss and majority of the cases with sensorineural hearing loss (about 30%) whereas TYMPANOSCLEROSIS caused the most severe sensorineural hearing losses. Conclusion: The findings indicated that cholesteatoma and TYMPANOSCLEROSIS were the most common causes of both conductive and sensorineural hearing loss with TYMPANOSCLEROSIS as the cause of the most severe sensorineural hearing loss. However granulation tissue is the most common histopathology in patients with chronic otitis media at references and papers.      

Background: Middle ear inflammation and fluid accumulation are one of the most common childhood diseases. Untreated or chronic ear inflammation can lead to more serious complications, including hearing loss, eardrum rupture, adhesive otitis media, TYMPANOSCLEROSIS, temporal bone necrosis, and cholesteatoma. Ventilation tube insertion is one of the best treatments to cure these diseases. Objectives: This aimedto observe children suffering from earinflammationwhowere candidates for VT insertion surgeryandstudy surgical complications. Methods: A historical cohort study was performed, and 205 VT surgeries were studied. Demographic information of children (like age, sex, and family medical history) was gathered through their medical records and probable complications, including otorrhea, TYMPANOSCLEROSIS, atrophy, and eardrum rupture were noticed through medical examinations and interviews. Data were analyzed using descriptive statistics, chi-square test, independent t-test, Fisher’ s exact, and Mann-Whitney U-test. Results: The results showed that 57% of surgery cases were boys, and 43% were girls, both having no family medical history. Serous otitis with tonsillar hypertrophy was reported in 200 cases (97. 6%), which had concurrent adenoidectomy or adenotonsillectomy. The frequency of otorrhea, TYMPANOSCLEROSIS, atrophy, perforation, and serous otitis recurrence was 2%, 12. 2%, 6. 8%, 1. 5%, and 14. 1%, respectively. Serous otitis recurrence was reported in 3. 9% of cases with T-tube insertion. Conclusions: The findings of this study show no significant difference in surgical complications between the two groups of girls and boys. But studying the relationship between the age of patients and the timing of surgery shows that the mean age of girls is significantly higher.

Introduction: One of the main treatments of chronic otitis media with effusion is ventilation of the middle ear with a ventilation tube (VT). The objective of this study was to determine the incidence and the types of VT complications in children with otitis media with effusion in Ahwaz.Materials and Methods: In this prospective study, the medical records of 208 children (52 male and 35 female) in Imam Khomeini and Apadana hospitals were reviewed. The children were between 10 months and 6 years old. The patients were followed up 12-18 months after ventilation tube insertion. We reviewed age, sex, postoperative otorrhea, eardrum atrophy, TYMPANOSCLEROSIS and persistent perforation. In all these patients, the indication for surgery was chronic middle ear effusion. The data were analyzed and presented as numbers and percentages using SPSS17.0.Results: Transient otorrhea occurred in 12.5% and delayed otorrhea in 8.2%. Otorrhea non-responsive to medical treatment was seen in 1.9%. Complications after tympanostomy tube extrusion included atrophy (27.8%) myringosclerosis (37.9%), and persistent perforation (2.4%).The average extrusion time was 10.5±5 months (ranging between 3-22 months).Conclusion: After extrusion of the ventilation tube, patients should be followed up regularly for recurrence of OME. Myringosclerosis, tympanic membrane atrophy and otorrhea are the most common complications of otitis media with effusion. However, they are generally insignificant. Consequently, in the majority of these complications, there is no need for any treatment.

Background & Aim: Chronic otitis media (COH) refers to change of middle ear mucosa, usually associated with perforated tympanic membrane. However it may be accompanied by some etiology without tympanic membrane perforation. It presents with persistent or intermittent otorrhea, hearing loss and acute and serious complications may occur in its course. Chronic infection, due to it's nature, is irreversible and usually surgery is indicated, and various pathologies are noted. The aim of this study is to evaluate various pathologies in cases of COH that have undergone surgery, so a better clinical diagnosis prior to surgery is reached.Patients and Methods: In this prospective cohort study, one hundred patients with chronic otitis media were evaluated; 73 males and 27 females in various age ranges, by most frequency 20-30 year olds were evaluated. Preoperative eudiometry and radiology were done and then patients were operated.Results: After data collection and analysis, this result was obtained: 86% granulation tissue, 18% cholesteatoma, 32% TYMPANOSCLEROSIS, 4% cholesterol granuloma and 71% ossicular change.Conclusion: Chronic otitis media presents with hearing loss or otorrhea and may be due various etiologies, most commonly by sequence granulation tissue, cholesteatoma, TYMPANOSCLEROSIS, and cholesterol granuloma. Clinical evaluation of the pathology is useful for clearing matters such as treatment strategy, type of surgery, prognosis, and surgical outcome.

Background: The prevalence of acute purulent otitis media (APOM) complications is unknown in Iran, and no exact statistical data are exist. Materials and methods: This descriptive study was conducted on 2000 school-aged children (7-11 years) in Mianeh in 1995, to determine the prevalence of APOM complications. 100 children were randomly chosen through each primary school (10 girls' schools and 10 boys' schools). Then, complications including perforation of tympanic membrane, TYMPANOSCLEROSIS, neotympane, and serous otitis were surveyed using otoscopy; the size of adenoid was measured by radiology, and the size of tonsils was determined by direct observation.Results: 2000 school-aged children (M/F=I) have entered our study. The prevalence of tympanic membrane perforation, TYMPANOSCLEROSIS, neotympane, and serous otitis were determined 0.7%, 1.6%, 6.4%, and 4.8%, respectively.Conclusion: Results have revealed that considering APOM complications, Iran has a satisfactory status; however, educating parents and routine examinations in pre-school children could be helpful.

The main clinical presentation of patients with primary antibody deficiency (PAD) incorporates upper respiratory tract infections comprising otitis media, sinusitis and pneumonia. This study was designed to investigate clinical and paraclinical otological complications in major types of PAD.A cross sectional study was conducted on 55 PAD patients with diagnosis of selective IgA deficiency, common variable immunodeficiency (CVID), X-linked agammaglobulinemia (XLA), and hyper IgM syndrome. All patients underwent otological examinations, audiometry, and auditory brain stem response.Otological complications were detected in 54.5% of PAD patients. Conductive hearing loss was the main finding amongst PID patients (73.3%) followed by sensorineural hearing loss which was present in 8 cases. Otitis media with effusion (21.8%), chronic otitis media (27.2%), TYMPANOSCLEROSIS with intact tympanic membrane (5.4%) and auditory neuropathy (3.6%) were most important found complications. CVID and XLA patients with prophylactic usage of antibiotics had lower rate of audiological complications (p=0.04) and otitis media with effusion (p=0.027).As our results showed, asymptomatic otological findings were not rare in PAD patients, therefore, a systematic otological investigation is recommended as an integral part of the management and follow-up of these patients.