Chronic Otitis Media with Granulation Is a Poor Prognostic Factor for Hearing Improvement and Development of Intracranial Complications.

OBJECTIVES: Different types of chronic otitis media are distinguished based on the observed lesions in the middle ear mucous. Hearing improvement is a measurable effect of the surgical treatment of patients with chronic otitis media. Chronic cholesteatoma otitis media and chronic otitis media with inflammatory granulation have a tendency to damage the bone tissue, leading to the development of intratemporal and intracranial complications.

MATERIALS AND METHODS: A prospective analysis of patients who underwent surgery for the first time due to chronic otitis media from 2009 to 2012 was performed. Patients were divided into groups according to the abnormalities of the middle ear mucous observed during otosurgery. Special attention was given to patients diagnosed with chronic otitis media with inflammatory granulation and chronic cholesteatoma otitis media, which are characterized by a tendency to damage the bone tissue.

RESULTS: A total of 293 individuals met the criteria for inclusion in the study. The analysis showed that chronic otitis media with inflammatory granulation had an unfavorable effect on hearing improvement prognosticated postoperatively. Defects in the middle cranial fossa were observed to occur five times more often than defects in the posterior cranial fossa. These defects were usually observed with granulation tissue and rarely with the concurrence of cholesteatoma and granulation tissue.

CONCLUSION: The presence of granulation tissue is an unfavorable prognostic factor for improvement in air and bone conduction. The probability of exposing the dura mater of the brain is higher in cases with granulation tissue than in cases with cholesteatoma.