Modification of Surgical Procedures of Type 1 Tympanoplasty for Non-Cholesteatomatous Chronic Otitis Media

ORL ◽  
2009 ◽  
Vol 71 (1) ◽  
pp. 71-73 ◽  
Author(s):  
Akinobu Kakigi ◽  
Taizo Takeda ◽  
Hiroaki Nakatani ◽  
Kenichi Kozakura ◽  
Shoichi Sawada ◽  
...  
Author(s):  
Arindam Das ◽  
Sandipta Mitra ◽  
Debasish Ghosh ◽  
Arunabha Sengupta

<p class="abstract"><strong>Background:</strong> The objective of the study was to investigate the effect of contralateral ear status on the success rate (anatomical closure) of type 1 tympanoplasty.</p><p class="abstract"><strong>Methods:</strong> The study is a prospective observational study comprising of 60 patients diagnosed with chronic otitis media, who underwent type 1 tympanoplasty during 2016-2018 in a tertiary care hospital.  </p><p class="abstract"><strong>Results:</strong> In our study, contralateral ear was normal in 40 (66.7%) cases &amp; diseased in 20 (33.3%) cases. Success rate of type 1 tympanoplasty in patients with normal contralateral ear was 90% (n=36) but success rate was only 60% (n=12) in diseased contralateral ear. This was statistically significant (p=0.006).</p><p class="abstract"><strong>Conclusions:</strong> Our study revealed that the status of the opposite ear is an individual prognostic factor for type 1 tympanoplasty. In other words, graft-healing rates are poorer in individuals whose opposite ears are atelectatic or perforated because of chronic otitis media.</p>


2016 ◽  
Vol 12 (1) ◽  
pp. 28-31 ◽  
Author(s):  
Tzu-Yen Huang ◽  
Kuen-Yao Ho ◽  
Ling-Feng Wang ◽  
Chen-Yu Chien ◽  
Hsun-Mo Wang

Author(s):  
Kiran Gangadar S. ◽  
G. Priyadarshini

<p class="abstract"><strong>Background:</strong> Tympanoplasty is a surgical procedure for closing the tympanic membrane perforation and reconstructing the tympanic membrane and hearing, commonly after trauma and chronic otitis media. The aim of the study was to compare the clinical and audiological outcomes of tympanoplasty with or without anterior tucking.</p><p class="abstract"><strong>Methods:</strong> In this prospective study, 50 patients with chronic otitis media (COM) were divided into two groups. Group 1 underwent type 1 tympanoplasty with anterior tucking method, and group 2 underwent type 1 tympanoplasty without anterior tucking. The result was measured on graft uptake and hearing outcome at 6 months postoperatively by performing pure tone audiometry.  </p><p class="abstract"><strong>Results:</strong> The hearing improvement was almost the same in both the groups. Graft uptake was good in type 1 tympanoplasty with tucking (96%) when compared to without tucking tympanoplasty (92%). Complications like residual perforation were seen in both groups equally. Anterior marginal blunting was noted (8%) in type 1 tympanoplasty with tucking.</p><p class="abstract"><strong>Conclusions:</strong> The hearing improvement of type-1 tympanoplasty with anterior tucking and without anterior tucking is the same. Type-1 tympanoplasty with anterior tucking has a better graft acceptance. The only disadvantage of type-1 tympanoplasty with anterior tucking is anterior marginal blunting.</p>


Author(s):  
Shreyash C. S. ◽  
Rajneesh . ◽  
Rahul S.

<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>


Author(s):  
Nitin Sharma ◽  
Pritosh Sharma ◽  
V. P. Goyal ◽  
Kumar Gaurav Sharma

<p class="abstract"><strong>Background:</strong> Type 1 tympanoplasty is a surgical technique used to restore the integrity of tympanic membrane as well as to improve hearing level in patients with large central perforations (inactive mucosal chronic otitis media).</p><p class="abstract"><strong>Methods:</strong> This is a randomized prospective study of 12 month duration from January 2017 to December 2017 in 100 patients of chronic otitis media inactive mucosal type with large central perforation admitted in the E.N.T department at Geetanjali Medical College and Hospital, Udaipur.  </p><p class="abstract"><strong>Results:</strong> The graft uptake rate in the present study was found to be 96% and 90% respectively in interlay and underlay techniques. Post operatively after 12 weeks mean air bone gap was maximum reduced in Interlay tympanoplasty.</p><p class="abstract"><strong>Conclusions:</strong> The present study showed that Interlay technique had a better graft take rate as well as hearing improvement in large central perforation of chronic otitis media than the underlay technique.</p>


Author(s):  
Amrita Chowdhury ◽  
Shatabdi Das

<p class="abstract"><strong>Background:</strong> Chronic otitis media (COM) is a widespread disease in the developing countries. It is treated by tympanoplasty, traditionally performed with the microscope which limits the visual field in the deep recesses of the middle ear, especially in narrow external auditory canal. Using endoscope has minimised these difficulties by providing a wide field view with angled magnification, reducing the duration of surgery. The advantages and disadvantages of both techniques is evaluated in our study.</p><p class="abstract"><strong>Methods:</strong> In this observational study, 60 patients of tubotympanic COM between 12-60 years of age with small to medium sized central perforation and air-bone gap of less than 45 decibel were included. They were divided into two groups (group A and group B) of 30 patients each. Group A underwent microscopic type 1 tympanoplasty and group B underwent endoscopic type 1 tympanoplasty. The duration of the surgery, the post-operative improvement in hearing and the graft uptake was analysed after 3 months of surgery. The post-operative hospital stay duration was noted.  </p><p class="abstract"><strong>Results:</strong> The post-operative hearing improvement and the graft uptake after 3 months of the surgery was statistically not significant between the two groups. But the mean duration of the operation and the post-operative hospital stay was significantly lower in the endoscopic group with a p value &lt;0.05.</p><p class="abstract"><strong>Conclusions:</strong> Endoscopes are better in otological procedures as it reduces the surgical duration, provides better visibility, lessens the post-operative hospital stay, reducing the economic burden of the patient.</p>


Author(s):  
Raghunath Shanbag ◽  
J. S. Arunkumar ◽  
M. Sarath Chand ◽  
Santosh S. Garag

<p class="abstract"><strong>Background:</strong> Tympanic membrane perforation in chronic otitis media exposes the middle ear mucosa to exogenous source of infection and also produces conductive hearing loss. To overcome this problem various surgical techniques of tympanoplasty using different graft materials have been tried with varying degrees of success rate. The purpose of this study was to compare anterior tucking and cartilage support tympanoplasty with respect to graft uptake and hearing outcome.</p><p class="abstract"><strong>Methods:</strong> This prospective study comprised of 50 consecutive patients with chronic otitis media of tubo tympanic type during October 2015 to September 2017, which were divided into two groups. Group A (25 patients) underwent type 1 tympanoplasty with anterior tucking method, Group B (25 patients) underwent type 1 tympanoplasty with cartilage support. The primary result was measured in view of graft uptake &amp; hearing capacity outcome at 6 months post operatively by performing pure tone audiometry.  </p><p class="abstract"><strong>Results:</strong> In anterior tucking tympanoplasty group out of 25 patients, the graft uptake was good in 22 patients and 23 patients showed good improvement in hearing, while in cartilage support tympanoplasty group all the 25 patients the graft uptake was good and all showed good hearing improvement postoperatively. In our study both the groups have significant hearing improvement and in cartilage support tympanoplasty results were better.</p><p class="abstract"><strong>Conclusions:</strong> The aim of tympanoplasty is to treat middle ear and tympanic membrane defects. In this study we subjected the patients for anterior tucking and cartilage support tympanoplasty for two different groups respectively and both methods showed significant hearing improvement.</p>


2011 ◽  
Vol 65 (4) ◽  
pp. 293-297 ◽  
Author(s):  
Rajashri Mane ◽  
Balasaheb Patil ◽  
Anjana Mohite ◽  
V. V. Varute

Author(s):  
Abhay Kumar ◽  
Prabhu Narayan ◽  
Prem Narain ◽  
Jaypal Singh ◽  
Prateek Kumar Porwal ◽  
...  

<p class="abstract"><strong>Background:</strong> Leading cause of deafness in India is chronic suppurative otitis media. Most common cause of TM perforation is chronic suppurative otitis media. With this background this study was to compare hearing results, as well as graft takes for commonly preferred reconstruction techniques of the TM (i.e., temporalis fascia vs. cartilage) in tympanoplasty.</p><p class="abstract"><strong>Methods:</strong> The present study consists of 60 cases of C.S.O.M (TTD) which was divided into two groups with 30 cases in each group. In first group type1 tympanoplasty was done by Temporalis fascia technique. In second group type 1 tympanoplasty done by tragal cartilage with perichondrium technique. History and otoscopic examination along with pure tone audiometry was performed preoperatively. Postoperative hearing results and graft uptake were compared between two groups, all surgeries were performed through the post aural approach.  </p><p class="abstract"><strong>Results:</strong> Graft uptake results are better with tragal cartilage with perichondrium technique. Hearing improved significantly in both groups. Though this was slightly better in TFT, but not significant statistically.</p><p><strong>Conclusions:</strong> Graft uptake rates are better with the tragal cartilage with perichondrium technique in comparison of TFT and hearing results are almost equivalent with both techniques.</p>


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