scholarly journals Mobile, one stage, bilateral ear surgery for chronic otitis media patients in remote areas

2009 ◽  
Vol 123 (10) ◽  
pp. 1108-1113 ◽  
Author(s):  
P Homøe ◽  
H C Florian Sørensen ◽  
M Tos
Keyword(s):  
Otitis Media ◽  
Pure Tone ◽  
Chronic Otitis Media ◽  
Ear Surgery ◽  
Suppurative Otitis Media ◽  
Remote Areas ◽  
Pure Tone Average ◽  
One Stage ◽  
Air Conduction

AbstractObjectives:We evaluated the results of mobile, one stage, bilateral ear surgery conducted in Greenland, where chronic otitis media with and without suppuration is prevalent. The study aimed to increase the number of operations conducted and to reduce the cost of ear surgery in remote areas.Materials and methods:The study was longitudinal and prospective, with a two-year follow up. Seventeen East Greenlandic patients with bilateral chronic suppurative otitis media or chronic otitis media were selected. Their median age was 16 years; 53 per cent were female and 47 per cent male. Hearing was assessed using median air conduction pure tone average gain, and the ‘take rate’ (i.e. the percentage of total ears with a closed perforation) was evaluated.Results:All patients attended for follow up. Eighty-two per cent had at least one perforation closed, and the overall take rate was 65 per cent of the 34 ears. The median air conduction pure tone average gain after two years was 18 dB and 13 dB for the right and left ears, respectively. Fourteen patients (82 per cent) obtained an air conduction pure tone average hearing level of ≤25 dB in at least one ear. In total, 71 per cent of the patients were satisfied. There were no hearing hazards.Conclusions:The results of mobile, one stage, bilateral ear surgery conducted in Greenland for long-lasting chronic suppurative otitis media and chronic otitis media were acceptable and safe, and more ears underwent surgery at reduced cost compared with unilateral ear surgery.

Hearing loss in patients with extracranial complications of chronic otitis media

2017 ◽  
Vol 71 (3) ◽  
pp. 36-42
Author(s):  
Tomasz Przewoźny ◽  
Jerzy Kuczkowski
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Pure Tone ◽  
Chronic Otitis Media ◽  
High Tone ◽  
Suppurative Otitis Media ◽  
Perilymphatic Fistula ◽  
Pure Tone Average ◽  
Extracranial Complications ◽  
Total Deafness

Objective: A pure tone audiomety analysis of patients with extracranial complications of chronic suppurative otitis media (ECCSOM). Material and methods: We retrospectively analyzed audiometric data performed before treatment from 63 patients with ECCSOM (56 single, 7 multiple complications) including groups of frequencies. Results: The greatest levels of hearing loss were noted for 6 and 8 kHz (79.0 and 75.7 dBHL) and for the frequency groups high tone average (76.1 dBHL). As regards the severity of hearing impairment in pure tone average the prevalence of complications was as follows: labyrinthitis (77.8±33.6 dBHL), facial palsy (57.1±14.3 dBHL), perilymphatic fistula (53.9±19.9 dBHL) and mastoiditis (42.2±9.5 dBHL) (p=0.023). Conclusions: Hearing loss in ECCSOM is dominated by mixed, high-tone, moderate type of hearing loss, most profound in labyrinthitis. In 11% of patients the complication causes total deafness.

scholarly journals Correlation of the Puretone Audiometry Findings with Intraoperative Findings in Patients with Chronic Suppurative Otitis Media

2015 ◽  
Vol 2 (1) ◽  
pp. 4
Author(s):  
Devashri Uday Patil ◽  
Kiran S. Burse ◽  
Shreeya Kulkarni ◽  
Vandana Sancheti ◽  
Chaitanya Bharadwaj
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Ossicular Chain ◽  
Chronic Suppurative Otitis Media ◽  
Suppurative Otitis Media ◽  
Number Of Patients ◽  
Operative Findings ◽  
Air Conduction

Chronic suppurative otitis media is one of the common otological conditions in India for which patients seek advice from an otorhinolaryngologist. Chronic suppurative otitis media is recurrent and progressive disease which is characterized with tympanic membrane perforation and suppurative discharge. Pure tone audiometry is the most common test used to evaluate auditory sensitivity. Since hearing loss is a common complication of chronic suppurative otitis media, we designed this study to evaluate preoperative pure tone audiometry findings in patients with chronic suppurative otitis media and its correlation with the intra-operative findings. <strong>Aims and Objectives:</strong> 1] To assess the intra-operative findings in patients with chronic suppurative otitis media. 2] To evaluate the correlation between the preoperative pure tone audiometry findings and intra-operative findings in patients with chronic suppurative otitis media. 3] To assess the type of hearing loss and degree of hearing loss in patients with chronic suppurative otitis media. <strong>Materials and Methods:</strong> This is an Observational study carried over a period of 3 years from August 2011 to August 2013. Total number of patients included in this study was 100. <strong>Result:</strong> Out of 100 patients studied 69 % of patients had Tubo-Tympanic type of CSOM, 31 % of patients had Attico-antral type of CSOM. In patients of Safe CSOM; Central perforation was seen in maximum cases 46.4 %, anterior central perforations was seen in 8.7 % cases, posterior central perforations seen in 20.2 % cases, and subtotal perforations seen in 24.63 % cases. In patients of Unsafe CSOM posterosuperior cholesteatoma was seen in maximum cases 67.74 %, and attic cholesteatoma was seen in 32.2 % cases. In safe CSOM patients all ossicles were intact and mobile whereas in unsafe CSOM patients only 4 patients had intact ossicular chain, while maximum patients had ossicular defect. <strong>Conclusion:</strong> Hearing loss depends on size of perforation. Hearing loss increases as the size of perforation increases. Average air conduction threshold and air bone gap did not differ significantly between various groups of ossicular defect. This shows us that neither air conduction nor air bone gap are reliable parameters on basis of which we can predict ossicular status preoperatively.

Stapedectomy following tympanoplasty

2001 ◽  
Vol 115 (6) ◽  
pp. 444-446 ◽  
Author(s):  
Leonard Berenholz ◽  
William Lippy ◽  
John Burkey ◽  
Arnold Schuring ◽  
Franklin Rizer
Keyword(s):  
Otitis Media ◽  
Pure Tone ◽  
Chronic Otitis Media ◽  
Rare Occurrence ◽  
Hearing Improvement ◽  
Hearing Gain ◽  
Pure Tone Average ◽  
History Of

The aim of this study was to evaluate the success of stapedectomy in patients who have previously had a tympanoplasty because of chronic otitis media (COM). Fourteen patients from a private otology practice had undergone tympanoplasty for COM and subsequently underwent stapedectomy. Measurements were taken of the air-bone gap (ABG) closure and pure tone average (PTA) which showed hearing improvement. Patients had a mean 36.9 dB PTA hearing gain with 79 per cent closing the ABG to within 20 dB. The need for stapedectomy alone is a rare occurrence for patients with a history of COM requiring a tympanoplasty. Hearing improvement following stapedectomy in these cases was significant, although somewhat less than following traditional stapedectomy in otosclerosis alone.

scholarly journals A study of hearing improvement after myringoplasties in Bir Hospital, Kathmandu

2012 ◽  
Vol 6 (4) ◽  
pp. 31-35 ◽  
Author(s):  
LK Yadav ◽  
D Shrestha ◽  
J Pradhananga
Keyword(s):  
Otitis Media ◽  
Chronic Suppurative Otitis Media ◽  
Medical Sciences ◽  
Hearing Improvement ◽  
Ear Surgery ◽  
Suppurative Otitis Media ◽  
Pure Tone Audiogram ◽  
Prime Concern ◽  
Number Of Patients ◽  
Air Conduction

Myringoplasty is one of the most common ear surgery performed for chronic suppurative otitis media tubo tympanic type. The prime concern for patients who are willing to undergo myringoplasty is hearing improvement. The aim of this study is to assess the improvement of hearing after myringoplasties for Chronic Suppurative Otitis Media tubo tympanic type. The total number of patients included in the study was 105. Myringoplasties were performed in 129 patients, and only those who had graft uptake i.e. 105, were selected for the study. Age of the patients varied from 13 to 45 years. Pure tone audiogram was done before the operation and four weeks after the operation, and air conduction thresholds were compared. It was found that 83% of the patients had some degree of hearing improvement after the operation. No significant complications were observed except that few patients complained of pain at the site of incision for harvesting the graft. Thus, this study shows that, patients can be assured that the chances of hearing improvement is acceptable and can undergo the operation without fearing complications. Journal of College of Medical Sciences-Nepal,2011,Vol-6,No-4, 31-35 DOI: http://dx.doi.org/10.3126/jcmsn.v6i4.6723

scholarly journals Relationship of Pure Tone Audiometry and Ossicular Discontinuity in Chronic Suppurative Otitis Media

2006 ◽  
Vol 21 (1-2) ◽  
pp. 5-10
Author(s):  
Ryner Jose C. Carrillo ◽  
Nathaniel W. Yang ◽  
Generoso T. Abes
Keyword(s):  
Logistic Regression ◽  
Otitis Media ◽  
Pure Tone ◽  
Operative Procedure ◽  
Multiple Logistic Regression Analysis ◽  
Chronic Otitis Media ◽  
Pure Tone Audiometry ◽  
Chronic Suppurative Otitis Media ◽  
Likelihood Ratios ◽  
Suppurative Otitis Media

Background: Pure tone audiometry is routinely used to determine conductive and sensorineural hearing status. Ossicular discontinuity is usually assessed intra-operatively. If ossicular discontinuity can be predicted by pure tone audiometry, perhaps the operative procedure of choice and prognosis for hearing can also be anticipated.   Objective: To determine the predictive value of preoperative pure tone audiometry on the presence of gross ossicular discontinuity in chronic otitis media.   Methods: Records of 205 patients, 7 to 75 years of age undergoing their first operation for chronic otitis media were reviewed. Preoperative audiograms and operative records for tympanomastoidectomy were evaluated. A total of 162 patients meeting inclusion criteria were included in the study. Likelihood ratios for positive and negative ossicular discontinuity for frequency-specific air-bone gap cut-offs were determined. Multiple logistic regression analysis for pure tone audiometry and operative findings to predict ossicular discontinuity was performed and a model for predicting ossicular discontinuity using logistic regression obtained.   Results and Conclusion: Frequency-specific air bone gap (ABG) cut-off values can predict ossicular discontinuity in chronic suppurative otitis media namely: < 20 dB ABG at 500 Hz predicts absence of ossicular discontinuity while > 50 dB ABG at 500 Hz, >30 dB ABG at 2 KHz, and > 50 dB ABG at 4 KHz best predict the presence of ossicular discontinuity in general. In the absence of cholesteatoma, the air bone gaps of <30 dB at 500 Hz and <20 dB at 1 KHz decrease probability of ossicular discontinuity from 32.97% to 2.54%. Combination of air bone gaps of >50 dB at 500 Hz, >20 dB at 2 KHz and >40 dB at 4 KHz increase the probability of ossicular discontinuity from 32.97% to 85.9%. These findings suggest that ossicular exploration may not be necessary for the former while an evaluation of the ossicular chain may be mandatory for the latter in the setting where cholesteatoma is not present or suspected.             Presence of cholesteatoma, granulation tissue and size of tympanic membrane perforation are important factors to consider in predicting ossicular discontinuity.   Keywords: air bone gap; audiometry, pure tone; ossicular discontinuity; otitis media, suppurative; logistic reg    

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 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 Role of pure tone audiometry in assessing ossicular status in patients with mucosal type of chronic otitis media

2020 ◽  
Vol 6 (5) ◽  
pp. 853
Author(s):  
Deepthy Das ◽  
Gurumani Sriraman ◽  
Valli Rajasekaran
Keyword(s):  
Otitis Media ◽  
Pure Tone ◽  
Chronic Otitis Media ◽  
Pure Tone Audiometry ◽  
Ossicular Chain ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Suppurative Otitis Media ◽  
Significant Difference

<p class="abstract"><strong>Background:</strong> Chronic suppurative otitis media (CSOM) is the disease of the middle ear cleft, which presents as hearing loss and ear discharge. This study aimed to assess the role of pure tone audiometry (PTA) in analysing the ossicular erosion in mucosal type of CSOM subjects.</p><p class="abstract"><strong>Methods:</strong> The current cross-sectional study was conducted among 60 people with mucosal CSOM.  Preoperative hearing was assessed by PTA. The surgeries were done and intra operative ossicular status were recorded. IBM SPSS 20 software was used for the analysis. Student t-test was used to correlate ossicular status and PTA findings.  </p><p class="abstract"><strong>Results:</strong> Among 60 subjects, 12 (20%) patients had eroded incus and 53 (88.3%) had normal stapes. The malleus was preserved in all patients. The result of our study showed that an average ABG of 58 dB at 500 Hz, 47 dB at 1 kHz, 41 dB at 2 kHz and 41 dB at 4 kHz in patients with   ossicular erosion. ABG for 500 Hz and 1 kHz were statistically significant for eroded incus. ABG for 500 Hz, 1 kHz, 2 kHz and 4 kHz were all statistically significant for eroded stapes.</p><p class="abstract"><strong>Conclusions:</strong> There is a significant difference between the PTA findings at different frequencies between intact and eroded ossicular chain. Pre-operative ABG helps us to assess the status of incus and stapes.</p>

Outcome of mobile ear surgery for chronic otitis media in remote areas

2008 ◽  
Vol 139 (1) ◽  
pp. 55-61 ◽  
Author(s):  
Preben Homøe ◽  
Christian Siim ◽  
Poul Bretlau
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Ear Surgery ◽  
Remote Areas
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