High-frequency conductive hearing loss as a diagnostic test for incomplete ossicular discontinuity in non-cholesteatomatous chronic suppurative otitis media

Chronic suppurative otitis media, with or without cholesteatoma, may lead to erosion of the ossicles and discontinuity of the ossicular chain. In incomplete ossicular discontinuity (IOD), partial erosion of the ossicles occurs, but some sound transmission is noted throughout the ossicular chain. Hig...

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Published in:PloS one 2017-12, Vol.12 (12), p.e0189997-e0189997
Main Authors: Sarmento, Jr, Krishnamurti M A, Sampaio, André Luiz Lopes, Santos, Tatiana Guthierre Targino, Oliveira, Carlos Augusto Costa Pires de
Format: Article
Language:English
Subjects:
Adolescent
Adult
Audiometry, Pure-Tone
Auditory defects
Biology and Life Sciences
Chains
Diagnosis
Diagnostic systems
Diagnostic tests
Discontinuity
Ear diseases
Ear Ossicles - pathology
Ear Ossicles - physiopathology
Female
Hearing loss
Hearing Loss, Conductive - complications
Hospitals
Humans
Likelihood ratio
Male
Medical diagnosis
Medical tests
Medicine and Health Sciences
Middle Aged
Military police
Otitis media
Otitis Media, Suppurative - complications
Otitis Media, Suppurative - pathology
Otolaryngology
Otology
Patients
People and Places
Prospective Studies
Risk factors
Sensitivity and Specificity
Sound transmission
Surgery
Young Adult
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creator Sarmento, Jr, Krishnamurti M A
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Oliveira, Carlos Augusto Costa Pires de
description Chronic suppurative otitis media, with or without cholesteatoma, may lead to erosion of the ossicles and discontinuity of the ossicular chain. In incomplete ossicular discontinuity (IOD), partial erosion of the ossicles occurs, but some sound transmission is noted throughout the ossicular chain. High-frequency conductive hearing loss (HfCHL) has been considered a hallmark of incomplete ossicular discontinuity. This study aims to evaluate the use of HfCHL as a preoperative predictor of IOD in patients with non-cholesteatomatous chronic suppurative otitis media. The HfCHL test was defined as the preoperative air-bone gap (ABG) at 4 kHz minus the average of the ABG at 0.25 and 0.5 kHz. The test was applied in 328 patients before surgery and compared to intraoperative findings as the gold standard. At surgery, 201 (61.3%) patients had an intact ossicular chain, 44 (13.4%) had a complete ossicular discontinuity, and 83 (25.3%) exhibited an IOD. The best cutoff level was calculated as 10 dB. The HfCHL test to diagnose IOD had a sensitivity of 83% and a specificity of 92% with a post-test probability of 78% and a likelihood ratio of 10.2. We concluded that the HfCHL test is highly effective in predicting IOD in patients with non-cholesteatomatous chronic suppurative otitis media and that it should be used routinely as a screening test prior to surgery.
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The HfCHL test to diagnose IOD had a sensitivity of 83% and a specificity of 92% with a post-test probability of 78% and a likelihood ratio of 10.2. We concluded that the HfCHL test is highly effective in predicting IOD in patients with non-cholesteatomatous chronic suppurative otitis media and that it should be used routinely as a screening test prior to surgery.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>29267386</pmid><doi>10.1371/journal.pone.0189997</doi><tpages>e0189997</tpages><orcidid>https://orcid.org/0000-0002-2334-0054</orcidid><oa>free_for_read</oa></addata></record>
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source ProQuest - Publicly Available Content Database; PubMed Central
subjects Adolescent
Adult
Audiometry, Pure-Tone
Auditory defects
Biology and Life Sciences
Chains
Diagnosis
Diagnostic systems
Diagnostic tests
Discontinuity
Ear diseases
Ear Ossicles - pathology
Ear Ossicles - physiopathology
Female
Hearing loss
Hearing Loss, Conductive - complications
Hospitals
Humans
Likelihood ratio
Male
Medical diagnosis
Medical tests
Medicine and Health Sciences
Middle Aged
Military police
Otitis media
Otitis Media, Suppurative - complications
Otitis Media, Suppurative - pathology
Otolaryngology
Otology
Patients
People and Places
Prospective Studies
Risk factors
Sensitivity and Specificity
Sound transmission
Surgery
Young Adult
title High-frequency conductive hearing loss as a diagnostic test for incomplete ossicular discontinuity in non-cholesteatomatous chronic suppurative otitis media
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