Endoscopic cartilage tympanoplasty in chronic otitis media

2015 ◽  
Vol 129 (11) ◽  
pp. 1073-1077 ◽  
Author(s):  
A Özgür ◽  
E Dursun ◽  
Ö Ç Erdivanli ◽  
Z Ö Coşkun ◽  
S Terzi ◽  
...  
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Type I ◽  
Success Rates ◽  
Hearing Improvement ◽  
Endoscopic Techniques ◽  
Cartilage Tympanoplasty ◽  
Graft Success ◽  
Endoscopic Cartilage Tympanoplasty ◽  
Endoscopic Tympanoplasty

AbstractObjectives:The use of endoscopic techniques is becoming more widespread in otological and neuro-otological surgery. One such procedure, endoscopic tympanoplasty, is used in chronic otitis media treatment. This study aimed to analyse the results of endoscopic transcanal cartilage tympanoplasty.Methods:Data of tubotympanic chronic otitis media patients who underwent transcanal endoscopic type I cartilage tympanoplasty between June 2012 and May 2013 were analysed. The main outcome measures were graft success and hearing improvement.Results:Graft success rates were 94.3 per cent and 92.5 per cent at post-operative months one and six, respectively. Post-operative air–bone gap values were significantly improved over pre-operative values (p < 0.01).Conclusion:Transcanal endoscopic type I cartilage tympanoplasty is a minimally invasive, effective and reliable surgical treatment option for chronic otitis media.

Functional results of temporalis fascia versus cartilage tympanoplasty in patients with bilateral chronic otitis media

2011 ◽  
Vol 126 (1) ◽  
pp. 22-25 ◽  
Author(s):  
K Onal ◽  
S Arslanoglu ◽  
M Songu ◽  
U Demiray ◽  
I A Demirpehlivan
Keyword(s):  
Standard Deviation ◽  
Otitis Media ◽  
Chronic Otitis Media ◽  
Functional Results ◽  
Type I ◽  
Temporalis Fascia ◽  
Cartilage Tympanoplasty ◽  
The Mean ◽  
Graft Success ◽  
And Cartilage

AbstractObjectives:To compare the functional results of type I tympanoplasty performed with either temporalis fascia or a perichondrium and cartilage island flap, in patients with bilateral chronic otitis media.Method:The study included primary tympanoplasty cases with a subtotal perforation, an intact ossicular chain, a dry ear for at least one month and normal middle-ear mucosa, together with contralateral tympanic membrane perforation. Temporalis fascia tympanoplasty was undertaken in 41 patients, and cartilage tympanoplasty in 39 patients.Results:The graft success rate was 65.9 per cent for the fascia group and 92.3 per cent for the cartilage group. Post-operatively, the mean ± standard deviation air conduction threshold was 28.54 ± 14.20 dB for the fascia group and 22.97 ± 8.37 dB for the cartilage group, while the mean ± standard deviation bone conduction threshold was 11.71 ± 8.50 dB for the fascia group and 7.15 ± 5.56 dB for the cartilage group.Conclusion:In patients with bilateral chronic otitis media, cartilage tympanoplasty seems to provide better hearing results and graft success rates.

scholarly journals A Comparative Study of Endoscopic versus Microscopic Cartilage Type I Tympanoplasty

2019 ◽  
Vol 24 (01) ◽  
pp. e80-e85 ◽  
Author(s):  
Dipesh Shakya ◽  
Arun KC ◽  
Ajit Nepal
Keyword(s):  
Comparative Study ◽  
Success Rate ◽  
Demographic Data ◽  
Operation Time ◽  
Type I ◽  
Success Rates ◽  
Type I Tympanoplasty ◽  
Graft Success ◽  
Retrospective Comparative Study ◽  
Endoscopic Tympanoplasty

Abstract Introduction The use of endoscope is rapidly increasing in otological and neuro-otological surgery in the last 2 decades. Middle ear surgeries, including tympanoplasty, have increasingly utilized endoscopes as an adjunct to or as a replacement for the operative microscope. Superior visualization and transcanal access to diseases normally managed with a transmastoid approach are touted as advantages with the endoscope. Objectives The present study aimed to compare the outcomes of endoscopic and microscopic cartilage tympanoplasty (Type I) Methods This was a retrospective comparative study of 70 patients (25 males and 45 females) who underwent type I tympanoplasty between March 2015 and April 2016. The subjects were classified into 2 groups: endoscopic tympanoplasty (ET, n = 35), and microscopic tympanoplasty (MT, n = 35). Tragal cartilage was used as a graft and technique used was cartilage shield tympanoplasty in both groups. Demographic data, perforation size of the tympanic membrane at the preoperative state, operation time, hearing outcome, and graft success rate were evaluated. Results The epidemiological profiles, the preoperative hearing status, and the perforation size were similar in both groups. The mean operation time of the MT group (52.63 ± 8.68 minutes) was longer than that of the ET group (48.20 ± 10.37 minutes), but the difference was not statistically significant. The graft success rates 12 weeks postoperatively were 91.42% both in the ET and MT groups, that is, 32/35; and these values were not statistically significantly different. There was a statistically significant improvement in hearing within the groups, both pre- and postoperatively, but there was no difference between the groups. Conclusion Endoscopic tympanoplasty is a minimally invasive surgery with similar graft success rate, comparable hearing outcomes and shorter operative time period as compared to microscopic use.

Comparative study of efficacy of graft placement with and without anterior tagging in type one tympanoplasty for mucosal-type chronic otitis media

2011 ◽  
Vol 126 (2) ◽  
pp. 125-130 ◽  
Author(s):  
P Hosamani ◽  
L Ananth ◽  
S B Medikeri
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Type I ◽  
Graft Material ◽  
Hearing Improvement ◽  
Hearing Results ◽  
Graft Placement ◽  
Type I Tympanoplasty ◽  
Suitable Technique

AbstractObjectives:To assess the efficacy of anterior tagging of graft material with respect to graft uptake and hearing results, in type I tympanoplasty.Study design:Prospective, randomised, cohort study.Methods:Sixty patients with chronic otitis media of the mucosal type, with pars tensa perforations, were included in the study. Patients were randomly allocated to two groups: group one underwent type one tympanoplasty with anterior tagging, while group two underwent type one tympanoplasty without anterior tagging. Follow up included evaluation of graft uptake and hearing improvement.Results:There were 33 patients in group one and 27 patients in group two. The overall incidence of successful graft uptake was 96.96 per cent in group one and 81.5 per cent in group two. Closure of central and posterior perforations was successful in 100 per cent of both groups. Closure of anterior and subtotal perforations was successful in 95.45 per cent of group one and 54.54 per cent of group two.Conclusion:Type one tympanoplasty with anterior tagging of graft material is a suitable technique for anterior and subtotal perforations.

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>

scholarly journals Paediatric Type I Cartilage Tympanoplasty with or without Concomitant Adeno-tonsillectomy – An Institutional Experience

2020 ◽  
Vol 28 (2) ◽  
Author(s):  
Santanu Dutta ◽  
Soumya Ghatak ◽  
Somnath Saha
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Type I ◽  
Age Group ◽  
Hearing Gain ◽  
Cartilage Tympanoplasty ◽  
Paediatric Age ◽  
Type I Tympanoplasty ◽  
Group 2 ◽  
Group 1

Introduction                                                                           In the management of COM in paediatric age group, eradication of the septic foci in the tonsil and the adenoids while addressing the dysfunction of Eustachian tube play a key role This study aims to assess the success rate of type I tympanoplasty with cartilage graft in mucosal type of chronic otits media in paediatric age group and finally, whether concomitant adeno-tonsillectomy plays any role in outcome of surgery or curing the disease process.                                    Materials and Methods                                                          A prospective clinical study was done over a period of one and half years amongst 59 patients, aged between 5 and 12 years, presenting with chronic otitis media with dry central perforation of ear-drum and pure conductive hearing loss. Patients were divided into two groups. Group 1 (n1= 22) underwent type I cartilage tympanoplasty with adenoidectomy/ tonsillectomy/ both in the same sitting and Group 2 (n2= 37) underwent type I cartilage tympanoplasty without any adeno-tonsillectomy.                                                                   Results                                                                                              Graft uptake was 86.4% in Group 1 at 6 months post-operative follow up while that in Group 2 was found to be 86.5%. The mean hearing gain in two groups were found to be 15.91±6.54 dB and 17.02±8.96 dB respectively. No significant difference was found between graft uptakes and hearing gains in two groups at the end of the study.                                                  Conclusion                                                                              Type I cartilage shield tympanoplasty, may be considered as an effective management strategy of paediatric chronic otitis media, mucosal disease. Type I tympanoplasty with concomitant adeno-tosillectomy did not prove to be better than type I tympanoplasty alone in terms of anatomic closure of tympanic perforation and hearing gain.

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>

A comparative study of endoscopic cartilage myringoplasty used to treat wet and dry ears with mucosal-type chronic otitis media

2020 ◽  
Vol 134 (9) ◽  
pp. 773-778
Author(s):  
Z Lou ◽  
X Li
Keyword(s):  
Comparative Study ◽  
Success Rate ◽  
Tympanic Membrane ◽  
Otitis Media ◽  
Chronic Otitis Media ◽  
Success Rates ◽  
Hearing Gain ◽  
Tympanic Membrane Perforations ◽  
The Difference ◽  
Graft Success

AbstractObjectiveThe outcomes of dry and wet ears were compared following endoscopic cartilage myringoplasty performed to treat chronic tympanic membrane perforations in patients with mucosal chronic otitis media.MethodsPatients with chronic perforations, and with mucosal chronic otitis media with or without discharge, were recruited; all underwent endoscopic cartilage myringoplasty. The graft success rate and hearing gain were evaluated at six months post-operatively.ResultsThe graft success rates were 85.9 per cent (67 out of 78) in dry ears and 86.2 per cent (25 out of 29) in wet ears; the difference was not significant (p = 0.583). Among the 29 wet ears, the graft success rates were 100 per cent in 11 ears with mucoid discharge and 77.8 per cent in the 18 patients with mucopurulent otorrhoea.ConclusionThe wet or dry status of ears in patients with chronic perforations with mucosal chronic otitis media did not affect graft success rate or hearing gain after endoscopic cartilage myringoplasty. However, ears with mucopurulent discharge were associated with increased failure rates and graft collapse, whereas ears with mucoid discharge were associated with higher graft success rates.

scholarly journals Transcanal Endoscopic Tympanoplasty for Pediatric Patients Under 15 Years of Age With Chronic Otitis Media

2020 ◽  
Vol 13 (1) ◽  
pp. 41-46 ◽  
Author(s):  
Sungsu Lee ◽  
Hyong-Ho Cho
Keyword(s):  
Hospital Stay ◽  
Otitis Media ◽  
Pediatric Patients ◽  
Chronic Otitis Media ◽  
Microscopic Technique ◽  
Hearing Gain ◽  
Group 2 ◽  
Graft Success ◽  
Endoscopic Tympanoplasty ◽  
Group 1

Objectives. To evaluate the results of transcanal endoscopic tympanoplasty for pediatric patients with chronic otitis media (COM) and compare them to that of the previously standard microscopic assisted tympanoplasty technique.Methods. The patients were divided into two groups based on the operative method. Group 1 underwent tympanoplasty with a totally endoscopic assisted technique (n=21, 24 ears), and group 2 underwent tympanoplasty with the conventional microscopic technique (n=14, 15 ears). We used a transcanal approach in group 1 and a postauricular approach in group 2. In group 1, there were 15 cases of simple COM and nine cases of adhesive otitis media. In group 2, only 15 cases of simple COM were present. We analyzed the outcomes in terms of the hearing gain according to the surgical method and COM type, operation time, hospital stay after surgery, and graft success rate.Results. Postoperative hearing gain results including air conduction (AC) thresholds and air-bone gap (ABG) were not significantly different between the two groups (P>0.05). In both the groups, significant improvement in the postoperative AC and ABG was observed compared to the preoperative hearing. The hospital stay after surgery was significantly shorter in group 1 than the group 2: 2.1±0.4 days and 4.8±0.9 days (P<0.001), respectively. The intact graft success rate was 91.6% in group 1 and 93% in group 2; the values were not significantly different (P>0.05). There was neither intra- nor postoperative complications.Conclusion. Transcanal endoscopic ear surgery technique is more conservative than microscopic approach and can be performed in pediatric patients under 15 years of age with COM. Moreover, it offers similar surgical results compared to traditional microscopic technique, and a shorter operative time and hospital stay after surgery are the advantages of this technique.

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

2020 ◽  
Vol 18 (1) ◽  
pp. 44-48
Author(s):  
Lok Ram Verma ◽  
Dhundi Raj Paudel
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Inactive Disease ◽  
Type I ◽  
Hearing Improvement ◽  
Beneficial Effects ◽  
Cortical Mastoidectomy ◽  
Group A ◽  
Group B

Introduction: Role of cortical mastoidectomy in tympanoplasty for Chronic Otitis Media Mucosal inactive disease is controversial. Some arguments are in favor and suggest that cortical mastoidectomy increases the air reservoir in the mastoid and also help in achieving the patency of aditus but others believe that the ingrowths of squamous epithelium, potential for injury to the inner ear structures and facial nerve during mastoid surgery outweighs the beneficial effects on tympanic membrane healing. Aims: To assess the hearing improvement and graft uptake in patients undergoing Tympanoplasty and Tympano-mastoidectomy in chronic otitis media mucosal inactive disease. Methods: This was a comparative study comprises of 50 patients with Chronic Otitis Media Mucosal inactive ear, conducted in the patients attending the department of ENT in NGMC teaching hospital from Nov 2017 to May 2019. All cases were operated during a period of one half year. 25 patients were selected for tympanoplasty (Group A) and 25 patients were selected for Tympanoplasty with cortical mastoidectomy (Group B). Results: There were 14(28%) male and 36(72%) female, with mean age of 28. 36 years, ranging from minimum of 13 years to maximum 56 years. The postoperative audiograms were recorded after 3 months. Type I tympanoplasty with cortical mastoidectomy has better graft uptake (96%) as compared to without mastoidectomy (84%). Post-operative hearing improvement is almost equal in tympano-mastoidectomy (13.24 dB) and tympanoplasty (13.04 dB). Conclusion: Post-operative hearing gain almost equal in both study group but graft uptake was better with tympano-mastoidectomy then tympanoplasty alone in present study.

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