Influence of severity and localization of adhesive processes in middle ear in chronic suppurative otitis media on level of hearing loss

Chronic otitis media is a common and socially significant disease that leads to hearing loss. One of the reasons for hearing loss in chronic otitis media is the adhesive process in the middle ear. Forming adhesions and scar conglomerates can connect the elements of the sound-conducting chain to each other and to the surrounding walls, leading to a decrease in their mobility. Currently, the influence of the severity and localization of adhesive processes on the level of hearing loss has not been sufficiently studied. Patients and methods. This study conducted a retrospective-prospective analysis of 56 patients diagnosed with chronic otitis media, accompanied by adhesive processes in the middle ear, who underwent tympanoplasty at the Saint Petersburg Research Institute of Ear, Nose, Throat, and Speech in the period from 2021 to 2023. Patients were divided into groups depending on the severity and location of scars and adhesions. Pure tone threshold audiometry in the speech frequency zone, preoperative computed tomography scans of the temporal bones, and intraoperative findings were evaluated. Results. Data were obtained confirming the influence of the severity and localization of scar-adhesive processes in the middle ear on the level of hearing loss. Conclusion. It was found that the involvement of the incudostapedial joint in the scar-adhesive process has a significant impact on the level of hearing loss, even in patients with a mild process involving only the auditory ossicles.