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 Is Allergic Rhinitis a Factor That Affects Success of Tympanoplasty?

2016 ◽  
Vol 59 (1) ◽  
pp. 10-13
Author(s):  
Elif Ersoy Callioglu ◽  
A. Sami Bercin ◽  
Hayati Kale ◽  
Togay Muderris ◽  
Sule Demirci ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Success Rate ◽  
Middle Ear ◽  
Success Rates ◽  
Type 1 Tympanoplasty ◽  
Significant Difference ◽  
Patient Groups ◽  
The Difference ◽  
Graft Success

Objective: The aim of the present study was to investigate the effect of allergic rhinitis on the success of the operation in chronic otitis surgery by using score for allergic rhinitis (SFAR). Materials and Methods: In the present study; 121 patients, who underwent type 1 tympanoplasty were examined retrospectively. SFAR of all patients were recorded. The graft success rates of 26 patients with allergic rhinitis (AR) and 95 patients with no allergic rhinitis group (NAR) were compared. Results: While the graft success rate in NAR group was 89.5%, this rate was 80.8% in the AR group. However, the difference between groups was not statistically significant (p = 0.311). Conclusion: These findings suggest that allergic rhinitis decreases the graft success rate of the pathologies occurring in eustachian tube, middle ear and mastoid although statistically significant difference wasn’t found. Prospective studies with larger patient groups are required in order to evaluate this pathology.

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.

scholarly journals OUTCOMES OF CIRCUMFERENTIAL V/S ANTERIOR TUCKING TYMPANOPLASTY TECHNIQUE IN INACTIVE MUCOSAL CHRONIC OTITIS MEDIA WITH SUBTOTAL PERFORATIONS: A PROSPECTIVE OBSERVATIONAL STUDY

2021 ◽  
pp. 95-98
Author(s):  
Sultan Singh Rulania ◽  
Sushma Mahich ◽  
Rekha Harshvardhan
Keyword(s):  
Observational Study ◽  
Success Rate ◽  
Otitis Media ◽  
Uptake Rate ◽  
Prospective Observational Study ◽  
Chronic Otitis Media ◽  
Hearing Gain ◽  
Group I ◽  
The Mean ◽  
Group Ii

Objective: The objective of the study is to compare circumferential versus anterior tucking underlay tympanoplasty technique. Methods: In this prospective observational study, 100 patients with chronic otitis media (Inactive mucosal type) were included, who were randomly allocated in two groups; Group I which comprised of 50 patients in which tympanoplasty with anterior tucking was done, and Group II comprised of 50 patients in which circumferential flap tympanoplasty was done. Improvement in the hearing gain and graft uptake success rate was compared. Results: The mean air-bone gap (ABG) changed from 28.74 dB to 11.52 dB after anterior tucking with a mean change of 17.22 dB and this change was found to be statistically significant (p<0.001). Similarly, the mean ABG changed from 28.92 dB to 11.86 dB after a circumferential flap with a mean change of 17.06 dB and this change was also found to be statistically significant (p<0.001). There was a slightly better improvement (17.22 dB) in the anterior tucking group as compared to the circumferential flap (17.06 dB). This difference was, however, not found to be statistically significant (p=0.830). Three-month graft uptake rate in the anterior tucking group was found 92% and in the circumferential group was 94%. (p>0.05). Conclusions: Our study concluded that both techniques have almost the same results with good graft uptake. Results of hearing improvements in both techniques were also comparable.

scholarly journals The Effect of External Auditory Canal Packing Duration on Healing After Endoscopic Cartilage Myringoplasty

2020 ◽  
pp. 014556132092211
Author(s):  
Zhengcai Lou
Keyword(s):  
Success Rate ◽  
Tympanic Membrane ◽  
External Auditory Canal ◽  
Cartilage Graft ◽  
Early Group ◽  
Tympanic Membrane Perforations ◽  
Removal Time ◽  
Graft Success ◽  
Late Group ◽  
And Cartilage

Introduction: The external auditory canal (EAC) packing is widely used in otosurgery and is considered to promote hemostasis and to support tympanic membrane grafts. However, few studies have investigated the effects of packing removal time on healing. Objective: We investigated the effect of EAC packing duration on healing after endoscopic cartilage myringoplasty in patients with chronic tympanic membrane perforations (TMPs). Materials and Methods: Patients with chronic TMPs who underwent endoscopic “push-through” cartilage myringoplasty were divided into early and late groups based on the length of time before EAC packing was removed. The graft success rate, eardrum appearance, and hearing gain were assessed 3 months after surgery. Results: The study included 137 patients. Three months after surgery, the graft success rate was 83.5% (66/79) in the early group and 94.8% (55/58) in the late group ( P = .042). The graft was displaced in 8 (10.1%) patients in the early group and in 1 (1.7%) patient in the late group ( P = .050). No epithelialization was found on the surface of the grafts in the early group, whereas epithelialization was nearly complete 4 weeks after surgery in the late group. Conclusions: Delaying removal of the EAC packing after endoscopic cartilage myringoplasty may promote tympanic membrane better healing and cartilage graft epithelialization and improve the appearance of the eardrum.

Chondroperichondrial clip myringoplasty: a new technique for closure of tympanic membrane perforations

2013 ◽  
Vol 127 (6) ◽  
pp. 562-567 ◽  
Author(s):  
S Ahmed ◽  
N Raza ◽  
S Ullah ◽  
A Shabbir
Keyword(s):  
Tympanic Membrane ◽  
Chronic Otitis Media ◽  
Invasive Technique ◽  
Mucosal Disease ◽  
Tympanic Membrane Perforations ◽  
Select Group ◽  
Custom Made ◽  
A New Technique ◽  
Graft Success ◽  
Conventional Myringoplasty

AbstractObjective:This study aimed to evaluate the feasibility and efficacy of the recently described chondroperichondrial clip myringoplasty technique, and make comparisons with conventional myringoplasty techniques.Methods:The study comprised a select group of patients with chronic otitis media (mucosal disease only), with central tympanic membrane perforations affecting less than 50 per cent of the pars tensa, and an air–bone gap below 35 dB. A modified custom-made cartilage perichondrial graft was placed using the recently described ‘clip’ technique.Results:The graft success rate was 91.3 per cent. Post-operatively, the air–bone gap was within 10 dB in 52 per cent of cases and within 10–20 dB in 48 per cent of cases. There were few minor complications.Conclusion:Chondroperichondrial clip myringoplasty can be considered as an alternative minimally invasive technique for the repair of select cases of tympanic membrane perforations. This technique, which showed impressive results, was associated with minimum morbidity and reduced operative time.

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 The practices and philosophies of cartilage tympanoplasty in difficult and challenging circumstances: audiological and morphological perspectives

2021 ◽  
Vol 7 (2) ◽  
pp. 358
Author(s):  
Apoorva Kumar Pandey ◽  
Ajaz U. Haq ◽  
Sharad Hernot ◽  
Madhuri Kaintura ◽  
Aparna Bhardwaj ◽  
...  
Keyword(s):  
Success Rate ◽  
Pure Tone ◽  
Randomized Study ◽  
Chronic Otitis Media ◽  
Functional Results ◽  
Pure Tone Average ◽  
Cartilage Tympanoplasty ◽  
The Difference ◽  
Graft Success ◽  
Hearing Outcomes

<p class="abstract"><strong>Background:</strong> The main objective of the study was to assess the anatomical and functional results of cartilage tympanoplasty using full thickness cartilage graft (with or without perichondrium) reinforced with fascia in high risk situations.</p><p class="abstract"><strong>Methods:</strong> This prospective non-controlled, non-randomized  study included 124 cases of chronic otitis media who underwent cartilage (reinforcement) tympanoplasty (underlay) and ossicular reconstruction with or without mastoidectomy in following seven groups:  revision cases, atelectatic cases, subtotal perforation (dry), larger anterior perforations (dry), tympanosclerosis, cholesteatomatous ear, and wet (discharging) ears .  Graft success was accepted labelled as an intact graft at the end of six month postoperatively. At the same time, hearing results were also assessed by comparing pre- and post-operative pure tone average air-bone gap (PTA-ABG) of each group using Student “t” test and p&lt;0.05 was considered statistically significant for the hearing outcomes.  </p><p class="abstract"><strong>Results:</strong> Anatomical success rate in this series was 94.36%. The overall mean pre- and post- operative pure tone average air-bone gap (PTA-ABG) were 31.33±10.41 dB and 19.55±12.04 dB, respectively and the difference was statistically significant (p&lt;0.05). Best take up rates were observed in atelectatic and tympanosclerotic group i.e., 100% and 96.55% respectively.</p><p class="abstract"><strong>Conclusions:</strong> This study discusses the results of cartilage tympanoplasty in specifically indicated seven situation and reveals good anatomic results in each group (minimum success rate was 86.66% in wet ears) and statistically significant differences in mean pre- and post op PTA-ABG in groups except cholesteatoma and wet ear group.</p>

Endoscopic triple-C tympanoplasty: an alternative approach to anteriorly located tympanic membrane repair

2018 ◽  
Vol 132 (11) ◽  
pp. 1007-1009 ◽  
Author(s):  
H Demirhan ◽  
Ö Yiğit ◽  
B Hamit ◽  
M Çakır
Keyword(s):  
Success Rate ◽  
Tympanic Membrane ◽  
Operating Time ◽  
Case Series ◽  
Membrane Repair ◽  
Anterior Portion ◽  
Tympanic Membrane Perforations ◽  
Alternative Method ◽  
Graft Success

AbstractObjectiveAnteriorly located tympanic membrane perforations can negatively affect surgical success rates. This study aimed to present, using our case series results, endoscopic triple-C (composite chondroperichondrial clip) tympanoplasty as an alternative method in the repair of tympanic membrane anterior quadrant perforations.MethodsThis study included patients with a perforation sized greater than 3 mm, who had an anterior quadrant dominant perforation where the anterior portion could not be seen during microscopic examination; all underwent endoscopic triple-C tympanoplasty.ResultsOperating time was 30–79 minutes (mean, 46.6 minutes). The post-operative graft success rate at six months was 92 per cent (23 out of 25). Mean post-operative follow-up duration was 21.5 ± 7.3 months (range, 11–40 months), and no intratympanic cholesteatoma was observed.ConclusionEndoscopic triple-C tympanoplasty is a comfortable, minimally invasive alternative method to repair anterior tympanic membrane perforations. The graft success rate and the degree of recovery from hearing loss were in accordance with the literature. However, more reliable results may be obtained in a larger series with longer follow-up times.

scholarly journals Simultaneous Bilateral Same-Day Endoscopic Myringoplasty Using Tragal Cartilage From One Ear

2019 ◽  
Vol 99 (8) ◽  
pp. 522-527 ◽  
Author(s):  
Baklaci Deniz ◽  
Kuzucu Ihsan ◽  
Guler Ismail ◽  
Kum Rauf Oguzhan ◽  
Ozcan Muge
Keyword(s):  
Chronic Otitis Media ◽  
Operation Time ◽  
Entire Group ◽  
Success Rates ◽  
Endoscopic Myringoplasty ◽  
The Mean ◽  
The Difference ◽  
Group 2 ◽  
Graft Success ◽  
Group 1

The aim of this study is to investigate the outcomes of bilateral same-day endoscopic myringoplasty using tragal cartilage from one ear in patients with bilateral chronic otitis media. In this retrospective study, medical records of 62 (84 ears) patients aged between 18 and 65 years who underwent endoscopic myringoplasty at our center between January 2015 and December 2017 were evaluated. Patients were classified into 2 groups according to surgical procedure they received: unilateral myringoplasty (group 1) and bilateral same-day myringoplasty (group 2). The comparisons were made between groups in terms of anatomical graft success and functional outcomes. There were 40 patients in the unilateral group (group 1) and 22 patients in the bilateral same-day group (group 2). The graft success rates were 92.5% and 93.2% for groups 1 and 2, respectively ( P = .904). The mean preoperative air–bone gaps (ABGs) were 21.1 ± 7.1 and 20.5 ± 6.7 dB, respectively, whereas the mean postoperative ABGs were 8.1 ± 2.7 dB and 7.9 ± 3.0 dB, respectively. The difference between pre- and postoperative ABGs for the entire group was statistically significant ( P < .001). Mean hearing gain was 12.5 ± 11.0 dB and 15.6 ± 10.1 dB in groups 1 and 2, respectively, ( P = .183). Postoperative ABG was ≤10 dB in 33 (82.5%) and 36 (81.8%) ears in groups 1 and 2, respectively. The functional success rates were similar in both groups ( P = .582). The average lengths of operation time were 61.6 ± 12.5 minutes and 110.1 ± 25.2 minutes for groups 1 and 2, respectively. Bilateral same-day endoscopic myringoplasty using tragal cartilage from one ear seems to be a safe and satisfactory procedure with a good satisfactory success rate.

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.

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