Introduction: Chronic otitis media (COM) is an entity of high prevalence and worldwide distribution. Despite being studied in depth, its pathogenesis is still a matter of discussion. One of the theories for its pathogenesis is the continuum. According to this theory, otitis media is described as a sequence of events, initiated by an insult that would lead to a cascade of events. Based on the conception of the Continuum, we studied the contralateral ear of patients with COM. Study design: Clinical prospective randomized. Material and Method: 108 patients were included in this study. All had been diagnosed as having COM (with or without cholesteatoma) and were being followed by the Research on Middle Ear Pathologies Group of the Hospital de Clínicas de Porto Alegre. Otoendoscopy with optic fiber was carried out on the affected ear just as in the contralateral ear, witch was classified as normal or abnormal. Results: 59,2% of all patients had COM with cholesteatoma and 40,8% had COM without cholesteatoma. In 46,3% of patients the contralateral ear was found to have some abnormality. In the group of patients with COM with cholesteatoma, 57% had abnormal contralateral ear, and in the other group the contralateral ear was found to be abnormal in 39%. The abnormality more frequently found on both groups was retraction of the eardrum. Discussion: The results suggest that patients with COM have grater probability of having bilateral disease, witch corroborates the idea that COM is not only an isolated event on the middle ear, but a constitutional one, and, therefore, bilateral.
chronic otitis media; contralateral ear; cholesteatoma
