Cortical mastoidectomy in quiescent, tubotympanic, chronic otitis media: is it routinely necessary?

2008 ◽  
Vol 123 (4) ◽  
pp. 383-390 ◽  
Author(s):  
K V Bhat ◽  
K Naseeruddin ◽  
U S Nagalotimath ◽  
P R Kumar ◽  
J S Hegde
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Controlled Study ◽  
Hearing Improvement ◽  
Tertiary Referral Hospital ◽  
Suppurative Otitis Media ◽  
Disease Eradication ◽  
Cortical Mastoidectomy ◽  
Randomised Controlled Study ◽  
Randomised Controlled

AbstractObjective:This study aimed to compare outcomes for mastoidotympanoplasty and for tympanoplasty alone in cases of quiescent, tubotympanic, chronic, suppurative otitis media.Study design:Single-blinded, randomised, controlled study within a tertiary referral hospital.Methods:Sixty-eight cases were randomly allocated into two groups. In group one, 35 ears underwent type one tympanoplasty along with cortical mastoidectomy. In group two, 33 ears underwent type one tympanoplasty alone. Outcome measures were as follows: perforation closure and graft uptake, hearing improvement, disease eradication, and post-operative complications.Results:There were no statistically significant differences in hearing improvement, tympanic perforation closure, graft uptake or disease eradication, comparing the two groups at three and six months post-operatively.Conclusion:Mastoidotympanoplasty was not found to be superior to tympanoplasty alone over a short term follow-up period. Hence, it may not be necessary to undertake routine mastoid exploration at this stage of disease.

scholarly journals Outcome of ear surgeries in dry and wet ear

2017 ◽  
Vol 3 (3) ◽  
pp. 562 ◽  
Author(s):  
Shreyash C. S. ◽  
Rajneesh . ◽  
Rahul S.
Keyword(s):  
Success Rate ◽  
Otitis Media ◽  
Chronic Otitis Media ◽  
Success Rates ◽  
Hearing Improvement ◽  
Suppurative Otitis Media ◽  
Time Of Surgery ◽  
Type 1 Tympanoplasty ◽  
Cortical Mastoidectomy

<p class="abstract"><strong>Background:</strong> Chronic suppurative otitis media (CSOM) can present with dry and wet ear (discharging ear). It’s an accepted fact that an actively draining central perforation is not a contraindication for ear surgery. The discharging ear presents the otologists with the dilemma of operating on it or not, this is due to widespread belief that the success rate while doing ear surgeries on wet ears is decidedly inferior. Hence the present dissertation is intended to find the outcome of ear surgeries in dry and wet ear.</p><p class="abstract"><strong>Methods:</strong> The present study comprises of 60 patients who have undergone type 1 tympanoplasty with cortical mastoidectomy, at Fr Muller’s Medical College, Mangalore. These patients were divided into two groups- Wet and Dry, based on the presence or absence of ear discharge at the time of surgery respectively. Inclusion Criteria: Patients of age group 16-60 years and both sexes, with mucosal type of chronic otitis media who underwent type 1 tympanoplasty with cortical mastoidectomy. Exclusion criteria: Patients with squamosal type of chronic otitis media or with ossicular chain erosion. A comparative analysis was done on the hearing improvement and incidence of the graft uptake postoperatively between the two groups.</p><p class="abstract"><strong>Results:</strong> In dry group, complete graft uptake was seen in 90% cases, whereas in wet group, a graft uptake rate of 86.7% was achieved. The graft take up rate is better in high x socio-economic status. Higher take up rates were seen in small and medium perforation compared to subtotal perforations. Hearing improvement, assessed by mean gain of PTA at the end of 6th month postoperatively, was achieved in 86% cases in Wet group and 90% cases in Dry group. There was an average hearing improvement of 13.08 db in speech frequencies in 88.3% cases. The difference between the two groups was statistically insignificant.</p><p><strong>Conclusions:</strong> In our study, we found no statistically significant differences between the success rates of Wet and Dry group, either in terms of graft uptake or the hearing improvement. Thus, from our study, we conclude that the presence of ear discharge at the time of surgery does not affect the success rate of type 1 tympanoplasty. </p>

TO ASSESS THE OUTCOME OF ENDOSCOPIC INTERLAY TYMPANOPLASTY IN TERTIARY CARE CENTER

2021 ◽  
pp. 73-75
Author(s):  
Pasunuti Shravya ◽  
Jyothi Swarup ◽  
Vigeshwar RK
Keyword(s):  
Success Rate ◽  
Otitis Media ◽  
Care Center ◽  
Tertiary Care ◽  
Chronic Otitis Media ◽  
Hearing Improvement ◽  
Suppurative Otitis Media ◽  
Conducting Mechanism ◽  
Conductive Hearing ◽  
Middle Ear Cleft

Background: Chronic otitis media is an inammatory process in middle ear cleft which is treated by a common otological procedure tympanoplasty to reconstruct the tympanic membrane and to restore sound-conducting mechanism. Rigid endoscope in transcanal interlay tympanoplasty has signicant advantage as it provides magnied, and wide angle view, with better success rate and postoperative hearing gain. The Aims and objectives were to assess the outcome of endoscopic interlay tympanoplasty, in terms of graft uptake, hearing improvement and rate of complications in cases of inactive mucosal chronic suppurative otitis media. Methods: This prospective study was conducted for 1 year at our institution in 50 patients having conductive hearing loss with dry, central perforation. All patients underwent transcanal endoscopic interlay tympanoplasty and were followed up for 3months to determine the graft uptake, hearing improvement and rate of complications. Results: Graft uptake rate in the present study was found to be 98% with residual perforation as a complication in 2% patients and no other complications were encountered. Post operatively air bone gap (ABG) after 12 weeks found to be < 20 dB ABG in 84% patients. Conclusion: Endoscopic interlay tympanoplasty is a effective method with high success rate both in terms of graft uptake as well as post operative hearing improvement and can be implemented in all cases of inactive mucosal COM.

scholarly journals A clinical study of evaluation of tympanoplasty with mastoidectomy in mucosal chronic otitis media

2019 ◽  
Vol 6 (1) ◽  
pp. 163
Author(s):  
Ritesh Mahajan ◽  
Nidhi Abraham ◽  
Nagaraj T. M.
Keyword(s):  
Otitis Media ◽  
Disease Process ◽  
Chronic Otitis Media ◽  
Chronic Suppurative Otitis Media ◽  
Suppurative Otitis Media ◽  
Medical College ◽  
Cortical Mastoidectomy ◽  
A Prospective Study

<p class="abstract"><strong>Background:</strong> Chronic suppurative otitis media (CSOM) is one of the most common ear diseases in developing countries with a varying incidence of 3% to 57%. It the disease process is further divided into mucosal type and squamosal type depending on clinical presentation. The mainstay of therapy in CSOM remains surgery which aims at eradication of disease and restoring the hearing mechanism. The main objective of our study was to evaluate the changes and impact of tympanoplasty with mastoidectomy as a surgical treatment modality in mucosal type of CSOM.</p><p class="abstract"><strong>Methods:</strong> A prospective study was conducted in Rajarajeshwari Medical College and Hospital between November 2015 and June 2017, involving 50 patients with mucosal type of chronic otitis media. These patients, after complete clinical examination and hearing analysis, underwent tympanoplasty with cortical mastoidectomy. Follow-up of the patients was done at one month and three months after the surgery where the parameters recorded preoperatively were assessed.  </p><p class="abstract"><strong>Results:</strong> The graft uptake three months after the surgery was 94%. Patients reported a subjective improvement in symptoms of ear discharge, decreased hearing, earache and tinnitus to 94%, 70%, 86% and 78% respectively. There was hearing improvement in ears that had discharge preoperatively and those ears that did not.</p><p class="abstract"><strong>Conclusions:</strong> Chronic suppurative otitis media is a very common problem and it can lead to recurrent ear discharge and hearing problems. Timely intervention is necessary as early diagnosis results in good surgical outcomes and can make an impact on patient’s quality of life.</p>

scholarly journals A Prospective Comparative Study between Dry and Wet Tympanoplasty

2018 ◽  
Vol 01 (02) ◽  
pp. 083-088 ◽  
Author(s):  
Hepsiba Pothala ◽  
Sunita Shukla ◽  
Wasim Khan ◽  
Ravi Ramalingam ◽  
Kombupalayam Ramalingam
Keyword(s):  
Comparative Study ◽  
Otitis Media ◽  
Uptake Rate ◽  
Chronic Otitis Media ◽  
Hearing Improvement ◽  
Temporalis Fascia ◽  
Suppurative Otitis Media ◽  
Significant Difference ◽  
Prospective Comparative Study ◽  
Contralateral Ear

Abstract Background Tympanoplasty is the well-established procedure for closure of perforations of tympanic membrane. Study Design This study was a prospective comparative study. Objective The objective of this study was to compare the hearing improvement and graft uptake rate between dry and wet tympanoplasty performed on tubotympanic type of chronic suppurative otitis media. Materials and Methods One hundred forty patients with tubotympanic type of chronic otitis media were selected and categorized into dry and wet ears. Tympanoplasty was performed using temporalis fascia by underlay technique in all cases. Postoperatively, graft uptake rate and hearing improvement were analyzed. Results The graft uptake rate was equal in both dry and wet ears, which was statistically insignificant. There was no statistically significant difference in the hearing improvement between the dry ears and wet ears (χ – 2.39, p = 0.122). Conclusion Factors such as age, sex, and status of the contralateral ear and wet ear did not have any impact on the postoperative graft uptake of tympanoplasty. There was no difference in the graft uptake between the dry and wet ears and there was no statistically significant difference between hearing improvement in both and wet ears.

scholarly journals Endoscopic myringoplasty: outcome and hearing gain in inactive mucosal chronic otitis media

2019 ◽  
Vol 5 (2) ◽  
pp. 330
Author(s):  
B. T. Subramanya ◽  
S. Lohith ◽  
B. Sphoorthi
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Hearing Improvement ◽  
Suppurative Otitis Media ◽  
Hearing Gain ◽  
Endoscopic Myringoplasty ◽  
A Prospective Study ◽  
Postoperative Scar ◽  
Middle Ear Cleft

<p class="abstract"><strong>Background:</strong> Chronic otitis media is an inflammatory process in the middle ear cleft that poses serious health problem in developing countries. Myringoplasty is a common otological procedure to reconstruct the tympanic membrane to prevent recurrent otorrhea, and restore sound-conducting mechanism. The use of rigid endoscope in transcanal myringoplasty has significant advantage as it provides magnified, close up as well as wide angle view, less morbidity and early postoperative wound healing with better cosmetic results without compromising success rate and postoperative hearing gain. The aims and objectives of the study were to analyze the results of endoscopic transcanal interlay myringoplasty, in terms of graft uptake and hearing improvement in cases of chronic suppurative otitis media with inactive mucosal disease with central perforation.</p><p class="abstract"><strong>Methods:</strong> This is a prospective study conducted from January 2016 to August 2018 in 30 patients of inactive mucosal chronic otitis media (COM). All patients underwent transcanal endoscopic interlay myringoplasty and patients were called for regular follow up for 12 weeks and results were statistically analysed.  </p><p class="abstract"><strong>Results:</strong> The graft uptake rate in the present study was found to be 93.33%. Pre operatively mean air bone gap (ABG) was 27.33 dB and post operatively after 12 weeks mean air bone gap improved to 10.5 dB. Mean ABG gain was 16.33%.</p><p class="abstract"><strong>Conclusions:</strong> Endoscopic transcanal interlay myringoplasty with superiorly based TM flap is an effective technique over conventional microscopic technique in terms of graft uptake, hearing improvement, better postoperative scar and less morbidity in cases of inactive mucosal COM.</p>

scholarly journals A study of surgical outcomes of myringoplasty in active and inactive ears

2017 ◽  
Vol 4 (1) ◽  
pp. 148
Author(s):  
Vasim Ismail Patel ◽  
N. H. Kulkarni ◽  
Jyothi A. C. ◽  
ShriKrishna B. H.
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Group Differences ◽  
Hearing Improvement ◽  
Ear Surgery ◽  
Hearing Gain ◽  
Gain Rate ◽  
Graft Take ◽  
Cortical Mastoidectomy ◽  
Widespread Belief

<p class="abstract"><strong>Background:</strong> Chronic otitis media (COM) can present with inactive (dry) and active (wet) ear. It’s an accepted fact that an actively draining central perforation is not a contraindication for ear surgery. The discharging ear presents the otologists with the dilemma of operating on it or not, this is due to widespread belief that the success rate while doing ear surgeries on active ears is decidedly inferior. Hence the present study is intended to find the outcome of ear surgeries in inactive and active ear with objective to find the incidence of graft uptake and hearing improvement in both the groups.</p><p class="abstract"><strong>Methods:</strong> A total of 50 active ear (with mucoid discharge) and 52 inactive ears (not discharging at least 3 month before surgery) with mucosal chronic otitis media underwent myringoplasty with cortical mastoidectomy. Graft take and hearing gain rates 3 and 6 months after surgery were calculated for both groups and compared.  </p><p class="abstract"><strong>Results:</strong> The graft take rate was 90% for the active ear group and 94% for the inactive ear group. The hearing gain rate was 90% for the active ear group and 94% for the inactive ear group. Differences were found to be statistically insignificant for both graft intake (p=0.461) and hearing gain (p=0.543).</p><p><strong>Conclusions:</strong> The success of myringoplasty is not adversely affected by the presence of mucoid ear discharge at time of surgery, and outcomes are comparable to those of the opration done for inactive ears. </p>

scholarly journals Outcome of underlay versus interlay tympanoplasty in patients with inactive mucosal chronic otitis media with large central perforation: a retrospective comparative study

2020 ◽  
Vol 7 (1) ◽  
pp. 121
Author(s):  
Rajneesh . ◽  
Dinesh Valse ◽  
Shradha Pawar ◽  
Anil Kumar Doddamani
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Hearing Improvement ◽  
Tertiary Referral Hospital ◽  
Hospital Department ◽  
Central Perforation ◽  
Group A ◽  
Graft Success ◽  
Group B ◽  
Retrospective Comparative Study

<p class="abstract"><strong>Background:</strong> Aim and objective were to study the outcome of underlay versus interlay tympanoplasty in patients with inactive mucosal chronic otitis media with large central perforations in terms of graft uptake rate and hearing improvement.  </p><p class="abstract"><strong>Methods:</strong> The present study was conducted retrospectively on 110 patients of inactive mucosal chronic otitis media with large central perforation, 55 patients selected from each group undergoing underlay or interlay technique in a tertiary referral hospital, Department of ENT, ESIC Kalaburagi, Karnataka, from February 1 2018 to January 31, 2020.  </p><p class="abstract"><strong>Results:</strong> Total 110 patients were included in the study. Male:female ratio was 1:2.2. The age group in this study ranged from 13-50 years of age. Preoperative mean air bone gap in groups A and B was 30.28±6.62, and 30.18±6.87 dB and postoperative mean air bone gap was 19.44±7.66 and 15.13±6.3 dB. In both the groups a significant mean reduction in air bone gap was observed. Mean reduction was maximum in group B. Statistically, intergroup difference in reduction in air bone gap was highly significant (p&lt;0.001). Graft success rate being 89.09% and 94.54% in underlay (group A) and interlay (group B) respectively.</p><p class="abstract"><strong>Conclusions:</strong> Interlay is a better technique than underlay in chronic otitis media inactive mucosal disease with large central perforation in terms of hearing improvement and graft uptake.  </p>

scholarly journals Role of Cortical Mastoidectomy in the Management of Mucosal Chronic Suppurative Otitis Media

2021 ◽  
Vol 8 (7) ◽  
pp. 136-141
Author(s):  
Sumit Sharma ◽  
Chhavi Gupta ◽  
Richa Singh
Keyword(s):  
Otitis Media ◽  
Chronic Suppurative Otitis Media ◽  
Hearing Improvement ◽  
Suppurative Otitis Media ◽  
Type 1 Tympanoplasty ◽  
Cortical Mastoidectomy ◽  
Significant Difference ◽  
Group A ◽  
Group B

This is a comparative study done to evaluate outcome of type 1 Tympanoplasty with and without mastoidectomy in terms of hearing improvement and graft uptake. This is a prospective study done in 100 patients at a tertiary care referral centre during November 2018 to march 2020. Patients were divided in two groups, Group A consists of 50 patients in whom type 1 Tympanoplasty was done and in Group B 50 patients were there who had undergone Type 1 Tympanoplasty with cortical mastoidectomy. Patients were evaluated postoperatively at 2nd wk, 4th wk, 2nd month and 3rd month for graft uptake, disease clearance, and hearing improvement. PTA was done at 3rd month postoperatively. In our study we observed graft uptake in 94% of patients in Group A as compared to 98% of patients in Group B and in terms of hearing improvement there is not much difference in both the groups i.e. in Group A it is 13.996 ± 4.235 while in Group B it is 14.172 ± 5.381 P value is 1 which means there is no statistically significant difference in two groups. Though better results were observed for cortical mastoidectomy with Type 1 Tympanoplasty than Type 1 Tympanoplasty alone but the difference was insignificant. Keywords: Cortical Mastoidectomy; Mucosal Chronic Suppurative Otitis Media; CSOM.

scholarly journals Single Sitting Bilateral Myringoplasty: Outcomes and Complications

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M A Hassan ◽  
M S Hassaballah ◽  
P M Mikahail ◽  
M S D Mahmoud
Keyword(s):  
Hearing Loss ◽  
Success Rate ◽  
Tympanic Membrane ◽  
Otitis Media ◽  
Chronic Otitis Media ◽  
Psychological Trauma ◽  
Single Stage ◽  
Hearing Improvement ◽  
Suppurative Otitis Media ◽  
Graft Take

Abstract Background Tympanoplasty is the standard and well established procedure for closure of tympanic membrane perforations. Traditionally each ear drum is taken up for grafting sequentially in two different sittings. The reluctance to deal with both sides at the same sitting has been primarily due to a theoretical risk of iatrogenic sensory-neural hearing loss, need of bilateral ear canal gauze packing and chances of graft intake failure. Chronic Suppurative Otitis Media (CSOM) is a widely prevalent public health problem presenting with discomfort, hearing loss, otorrhea and psychological trauma. CSOM is characterized by an inflammatory process of the middle ear often associated with irreversible tissue alterations. It may be further classified into safe chronic otitis media and unsafe chronic otitis media according to the absence or presence of a cholesteatoma. Aim This study aim at assessing the single stage bilateral surgical procedure in bilateral tympanic membrane perforation caused by chronic otitis media as regard the graft take and hearing improvement as outcomes. Methodology A meta-analysis study is done to assess the feasibility and the possibility of operating the bilateral perforation in tympanic membrane in chronic otitis media cases on same session rather than doing it in separate sessions. The outcomes that were selected to evaluate such approach are graft take and hearing improvement. Hospital stay, cost of the operation and time were supposed to be evaluated however, there was no sufficient data to treat such outcomes in this meta analytic study upon that these outcomes are going to be appraised and stated bases on the available data. Results The graft take was evaluated on the bases paper by ototscopic examination post operative from 3 weeks to 3 months by closure of the perforation. It was estimated in this study to be 88%. This percent is matching the result obtained by Ihsan et al 2016 “who operated on 50 patients with a graft uptake rate of 86 %”, Olusesi et al, 2017 " with a total of 38 participants underwent either bilateral sequential same-day tympanoplasty (18 patients, 36 ears) or bilateral sequential different-day tympanoplasty (20 patients, 40 ears). The overall graft take rate was 88 per cent (32 out of 36 ears in the same-day tympanoplasty group, 35 out of 40 ears in the different-day tympanoplasty group; p = 0.96, odds ratio = 0.984)" (88 %), and Katsura et al, 2005 who revised the SUM using a 17 patients who underwent bilateral same-day surgery with a success rate of (85%). Conclusion Simultaneous bilateral myringoplasty is safe and effective as a single-stage operation with a high success rate as regard the graft take and hearing improvement.

Sign in / Sign up

Export Citation Format

Share Document