Endoscopic Type 1 Tympanoplasty in Chronic Otitis Media: Comparative Study with a Postauricular Microscopic Approach

2019 ◽  
Vol 161 (2) ◽  
pp. 315-323 ◽  
Author(s):  
Masafumi Ohki ◽  
Shigeru Kikuchi ◽  
Sunao Tanaka
Keyword(s):  
Success Rate ◽  
Otitis Media ◽  
Middle Ear ◽  
Chronic Otitis Media ◽  
Tympanic Membrane Perforation ◽  
Hearing Improvement ◽  
Surgical Time ◽  
Ear Surgery ◽  
Surgical Success ◽  
Membrane Perforation

ObjectiveTo compare surgical outcomes after tympanoplasty without ossiculoplasty for chronic otitis media between transcanal endoscopic ear surgery (TEES) and postauricular microscopic ear surgery (PAMES).Study DesignCase-control study.SettingTertiary care university hospital.Subjects and MethodsConsecutive patients ( N = 122) who had undergone tympanoplasty without ossiculoplasty for chronic otitis media were enrolled in this retrospective study and divided into 2 groups: TEES (n = 47) and PAMES (n = 75). Middle ear condition was graded with the middle ear risk index. Hearing, repair of tympanic membrane perforation, and surgical time were assessed.ResultsThe surgical success rate for hearing (air-bone gap ≤20 dB) was 95.7% in the TEES group and 84.0% in the PAMES group. Lower middle ear risk resulted in similar mean (95% CI) closure of air-bone gaps (TEES: 9.6, 6.5-12.6; PAMES: 8.0, 6.4-9.7; P = .333), whereas higher middle ear risk demonstrated significantly larger closure of air-bone gaps for the TEES group (10.1, 3.3-16.9) than the PAMES group (–0.2, –4.5 to 4.2; P = .009). The surgical success rate for repair of tympanic membrane perforation and surgical time were equivalent between TEES and PAMES.ConclusionUnder favorable conditions of the middle ear, TEES and PAMES resulted in similar hearing improvement by tympanoplasty without ossiculoplasty. However, under adverse conditions of the middle ear, TEES was a more beneficial approach for hearing improvement than PAMES.

scholarly journals A Correlative Study Between Size of Tympanic Membrane Perforation, Pure Tone Audiometry and Intraoperative Findings in Tympanoplasty

2018 ◽  
Vol 26 (1) ◽  
pp. 43-47
Author(s):  
Santosh U P ◽  
Sridurga J ◽  
Aravind D R
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Otitis Media ◽  
Middle Ear ◽  
Pure Tone ◽  
Chronic Otitis Media ◽  
Pure Tone Audiometry ◽  
Tympanic Membrane Perforation ◽  
Membrane Perforation ◽  
Operative Findings

Introduction             Chronic otitis media (COM) is a most common and prevalent disease of the middle ear. COM has been defined as a longstanding inflammatory condition of middle ear and mastoid, associated with perforation of the tympanic membrane. Tympanoplasties are common surgeries performed for chronic otitis media in inactive mucosal type. Any otological surgery may involve a menace/ hazard of hearing loss post operatively.             In this study, an attempt was made to correlate, size of tympanic membrane perforation, pure tone audiometry and intra-operative findings in tympanoplasties, results were analysed and conclusion drawn. Materials and Methods Forty patients attending ENT OPD with chronic otitis media (COM), inactive mucosal type, with conductive hearing loss undergoing tympanoplasties who were willing to participate in the study were selected.  Ear was examined pre-operatively to assess the size of perforation and then, pure tone audiometry (PTA) was done to assess the type of hearing loss and its severity. During tympanoplasty, middle ear was inspected for ossicular status and any other pathology was noted. Later, the size of tympanic membrane perforation, pure tone audiometry and intra operative findings were correlated with each other and analysed. Result  In small and medium sized perforation, PTA and intraoperative findings correlated with each other. Whereas, in large and subtotal perforation, there was no correlation. Conclusion             In small and medium sized perforation, middle ear inspection may not be necessary. Whereas, in large and subtotal perforation it is necessary. 

scholarly journals Comparative study of outcomes of type-1 tympanoplasty with and without anterior tucking

2020 ◽  
Vol 6 (4) ◽  
pp. 657
Author(s):  
Kiran Gangadar S. ◽  
G. Priyadarshini
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Chronic Otitis Media ◽  
Pure Tone Audiometry ◽  
Tympanic Membrane Perforation ◽  
Hearing Improvement ◽  
Type 1 Tympanoplasty ◽  
Membrane Perforation ◽  
Group 2

<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>

scholarly journals Effectiveness of transperforation myringoplasty in bilateral chronic otitis media patients undergoing contralateral tympanoplasty

2016 ◽  
Vol 131 (1) ◽  
pp. 64-68 ◽  
Author(s):  
A T Ihsan ◽  
K Ranjana
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Contralateral Side ◽  
Tympanic Membrane Perforation ◽  
Inclusion Criteria ◽  
Hearing Improvement ◽  
Membrane Perforation ◽  
Bilateral Surgery ◽  
A Prospective Study

AbstractObjectives:Bilateral tympanic membrane perforation closure is usually performed by otosurgeons in two sittings. However, in this study, transperforation myringoplasty was performed alongside contralateral tympanoplasty in a single sitting. The effectiveness of transperforation myringoplasty procedure and the benefits of single sitting bilateral surgery were evaluated.Methods:A prospective study of 50 selected patients with mucosal-type bilateral chronic otitis media was conducted. All patients underwent transperforation myringoplasty on the side that met the inclusion criteria and tympanoplasty on the contralateral side. Graft uptake and hearing improvement were evaluated after 6 months.Results:At the 6-month follow up, the graft uptake rate was 82 per cent, the hearing gain was 11.5 dB and the air–bone gap gain was 11.6 dB.Conclusion:This procedure offers perforation closure in a single sitting to patients with bilateral chronic otitis media who meet the inclusion criteria.

Experimental Pneumococcal Otitis Media: A Histopathologic Study

1980 ◽  
Vol 88 (5) ◽  
pp. 606-612 ◽  
Author(s):  
William L. Meyerhoff ◽  
Donald A. Shea ◽  
G. Scott Giebink
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Granulation Tissue ◽  
Endolymphatic Hydrops ◽  
Chronic Otitis Media ◽  
Tympanic Membrane Perforation ◽  
Middle Ear Mucosa ◽  
Diffuse Infiltration ◽  
Membrane Perforation ◽  
Histologic Changes

An animal model for pneumococcal otitis media was studied histologically at varying intervals postinoculation. Histologic changes generally associated with acute inflammation (edema, diffuse infiltration with polymorphonuclear leukocytes, and hemorrhage) occurred early in the disease while the ears were culture positive. Changes generally associated with chronic otitis media (lymphocyte infiltration and osteoneogenesis) occurred later in the course of the disease when the ears were culture negative. Metaplasia of middle ear mucosa and middle ear granulation tissue were observed as early as five days following inoculation. Middle ear granulation tissue was identified in 82% of all cases; cholesteatoma was seen in only one ear. Tympanic membrane perforation did not occur. Labyrinthitis and endolymphatic hydrops were fairly common findings. The former was identified in 56% of ears examined, and the latter, in 45%. These two conditions coexisted in 34% of ears studied, while endolymphatic hydrops alone occurred in 11%.

scholarly journals A multivariate analysis of chronic otitis related prognostic factors in determining hearing improvement in tympanoplasty

2013 ◽  
Vol 60 (4) ◽  
pp. 47-52
Author(s):  
Slobodan Spremo ◽  
Sanja Spiric ◽  
Dmitar Travar ◽  
Predrag Spiric ◽  
Mira Spremo
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Bone Erosion ◽  
Chronic Otitis Media ◽  
Ossicular Chain ◽  
Tympanic Membrane Perforation ◽  
Hearing Improvement ◽  
Membrane Perforation ◽  
Tube Function ◽  
Type Of Surgery

OBJECTIVE: The aim of this study was to evaluate which factors are best predictors of hearing improvement after tympanoplasty and to evaluate best functional outcome in different forms of pathology in the tympanic cavity and mastoid in chronic otitis media. METHODS: Prospective study included 120 patients who were operated for chronic suppurative otitis media and cholesteatoma in the ENT Department University Clinic Center Banja Luka from 2006 to 2011. Multiple linear regression analysis was used to measure which factors predict better hearing improvement. MAIN OUTCOME MEASURES: A model that evaluates factors related to chronic otitis media: ossicular chain integrity, tympanic tube function, tympanic membrane perforation, type of surgery and condition of tympanic and mastoid walls was used to predict postoperative hearing improvement. Hearing outcome was measured comparing preoperative to postoperative pure-tone average (PTA) and postoperative air-bone gap (ABG). RESULTS: Out of 120 operated patients, we performed primary surgery in 106 and revision surgery in 9 cases due to recurrent cholesteatoma. We observed high correlation and statistically significant contribution of ossicular chain pathology (b=-0.310, t=-3.01, p<0.05), and mastoid bone erosion or defects (b=2.05, t=2.05 , p<0.05), on the variance of PTA. The same variables were highly correlated with ABG closure: ossicular chain pathology (b=-0.230, t=-2.14, p<0.05), and mastoid bone erosion or defects (b= 2.05, t=2.08 , P<0.05). Variance of preoperative to postoperative PTA difference explained by the model as a whole was 24,7%, F(8,119)=4.54 , p<0.01. Variance of preoperative to postoperative ABG difference explained by the model as a whole was 18,3% F(8,119)=3.1, p<0.01. The predictive model in this study included 8 variables related to middle ear pathology proved to be superior to analyzing each variable separately. CONCLUSION: A model that evaluates factors related to chronic otitis media: ossicular chain integrity, tympanic tube function, tympanic membrane perforation, type of surgery and condition of tympanic and mastoid walls has significant predictive value for hearing assessment in tympanoplasty.

scholarly journals Outcome of mobile ear surgery units in Thailand

2009 ◽  
Vol 124 (4) ◽  
pp. 382-386 ◽  
Author(s):  
K Snidvongs ◽  
P Vatanasapt ◽  
S Thanaviratananich ◽  
M Pothaporn ◽  
P Sannikorn ◽  
...  
Keyword(s):  
Tympanic Membrane ◽  
Middle Ear ◽  
Hearing Threshold ◽  
Descriptive Study ◽  
Tympanic Membrane Perforation ◽  
Impaired Hearing ◽  
Hearing Improvement ◽  
Ear Surgery ◽  
Closure Rate ◽  
Membrane Perforation

AbstractObjectives:To evaluate the outcome of mobile ear surgery, in terms of tympanic membrane perforation closure, absence of otorrhoea and hearing threshold improvement.Study design:Descriptive study.Methods:The study enrolled patients with chronic ear disorders requiring surgery who presented to the mobile ear surgery unit at Sakaeo Hospital, Thailand, from 1 to 4 July 2008. The following data were recorded: pre-operative audiogram, post-operative middle-ear and mastoid infection, wound infection, graft condition, any complications, and post-operative audiogram. Patients were followed up at one week, two weeks, four weeks and 24 weeks post-operatively.Results:For the 31 cases of tympanic membrane perforation, the closure rate was 90.3 per cent. For the 32 patients with otorrhoea, the rate of ear dryness was 87.5 per cent. All 35 patients had impaired hearing initially; the rate of hearing improvement was 74.3 per cent (95 per cent confidence intervals = 56.7–87.5 per cent). Patients' mean hearing improvement was 22.9 dB.Conclusion:The assessed ear surgery procedures had good results.

scholarly journals Impact of depressive disorders on quality of life after middle ear surgery in patients with chronic otitis media

2020 ◽  
Author(s):  
Susen Lailach ◽  
Theresa Langanke ◽  
Thomas Zahnert ◽  
Susan Garthus-Niegel ◽  
Marcus Neudert
Keyword(s):  
Quality Of Life ◽  
Depressive Symptoms ◽  
Otitis Media ◽  
Middle Ear ◽  
Short Form ◽  
Chronic Otitis Media ◽  
Middle Ear Surgery ◽  
Ear Surgery ◽  
Sf 36

Abstract Purpose The aim of this study was to determine whether preoperative depressive symptoms influence health-related quality of life (HRQOL) after middle ear surgery in patients with chronic otitis media (COM). Methods This prospective clinical case study was conducted at a tertiary referral center. All 102 patients who had undergone middle ear surgery for COM were assessed clinically and by audiometric testing (pure tone audiometry) in pre- and postoperative settings. Disease-specific HRQOL was assessed by the validated chronic otitis media outcome test 15 (COMOT-15) and the Zurich chronic middle ear inventory (ZCMEI-21). General HRQOL was measured using the short form 36 (SF-36). Depressive symptoms were assessed using the patient health questionnaire (PHQ-D). The Charlson comorbidity index (CCI) was used to classify comorbidities. The middle ear status was determined using the ossiculoplasty outcome parameter staging (OOPS) index. Results After middle ear surgery, the total COMOT-15 and ZCMEI-21 scores improved significantly (p < 0.001). General HRQOL (total SF-36 score) was unaffected by surgery (p < 0.05). Patients without elevated depressive symptoms had significantly better total scores for the COMOT-15 (p < 0.01), ZCMEI-21 (p < 0.001), and for SF-36 (p < 0.001) postoperatively. The results of the multiple regression analyses show that, after adjusting for the OOPS, CCI, and hearing improvement, preoperative depressiveness was significantly associated with worse postoperative COMOT-15 and ZCMEI-21 outcome scores (β = 0.425 and β = 0.362, p < 0.001). Conclusion Preoperative depressiveness was an essential predictive factor for HRQOL in patients with COM. This should be considered during patient selection to provide more suitable preoperative counseling.

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