title: Decision making in patients with natural myringostapediopexy: A study of the contralateral ear.
abstract: Naturally occurring myringostapediopexy frequently results in minimal hearing loss and is asymptomatic. Management decisions in such ears, however, often hinge on an appraisal of evolution toward cholesteatoma. The study of the contralateral ear has been used by our research team to infer the progression of chronic otitis media. This cross-sectional, comparative study describes the clinical findings of the contralateral ear in a series of patients with myringostapediopexy. This study included a historical and current sample of 46 patients divided into a pediatric (≤18 years) and an adult group. Patient distribution according to sex was similar (52.2% male), and 56.5% were adults. Mean conductive hearing loss ranged from 14.1 to 21.2 dB in ears with myringostapediopexy and from 16.0 to 26.6 dB in the contralateral ears according to the frequency assessed. The contralateral ear was normal in only 19.6% of the cases of myringostapediopexy. Central tympanic membrane perforation was found in 6.5% of the cases; perforation-retraction, in 17.4%; moderate or severe retraction, in 28.3%; and cholesteatoma, in 28.3%. The prevalence of cholesteatoma in the contralateral ear in the pediatric and adult groups was not significantly different (p = 0.5; χ(2) test). The presence of significant abnormalities, particularly cholesteatoma, in the contralateral ears suggests a probable unfavorable progression in cases of myringostapediopexy and may influence management decisions.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Ramiro Barcelos, 2350, Porto Alegre, Rio Grande do Sul, Brazil. viviboms@gmail.com.
authors.forename: Viviane Bom
authors.initials: VB
authors.lastname: Schmidt
authors.forename: Sady Selaimen
authors.initials: SS
authors.lastname: da Costa
authors.forename: Letícia Petersen Schmidt
authors.initials: LP
authors.lastname: Rosito
authors.forename: Neil
authors.initials: N
authors.lastname: Sperling
authors.forename: Rodrigo Gonçalves
authors.initials: RG
authors.lastname: Dias
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D018424:Cholesteatoma, Middle Ear / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D006314:Hearing Loss, Conductive / Q000209:etiology / Q000523:psychology / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009225:Myringoplasty / Q000379:methods / Q000523:psychology*; D013199:Stapes / Q000002:abnormalities*; D013201:Stapes Surgery / Q000379:methods / Q000523:psychology*; D014432:Tympanic Membrane / Q000002:abnormalities* / Q000601:surgery; D055815:Young Adult