scholarly journals Prediction of hearing outcomes in chronic otitis media patients underwent tympanoplasty using ossiculoplasty outcome parameter staging or middle ear risk indices

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0252812
Author(s):  
Da Jung Jung ◽  
Hyun Ju Lee ◽  
Ji Song Hong ◽  
Dong Gyu Kim ◽  
Jae Yeon Mun ◽  
...  
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Risk Group ◽  
Risk Index ◽  
Chronic Otitis Media ◽  
Outcome Parameter ◽  
Korean Society ◽  
Risk Indices ◽  
The Mean ◽  
Hearing Outcomes

Purpose Ossiculoplasty outcome parameter staging (OOPS) and middle ear risk index (MERI) are the most commonly used indices for predicting prognosis of patients with chronic otitis media (COM). This study aimed to verify the efficiency of OOPS and MERI scores in predicting outcomes of patients with COM who underwent tympanoplasty. Methods We retrospectively reviewed the data of patients who underwent tympanoplasty (n = 526). OOPS, and MERI scores were collected. Hearing data were measured 1 day preoperatively, and 3 and 12 months postoperatively. Operation success was defined according to the Korean Society of Otology guidelines. Results For calculation of success, the ROC values of MERI were 0.551 at 12 months. ROC values of OOPS were 0.637 at 12 months. There were no significant differences in hearing variables among the three groups according to MERI. There were significantly favorable outcomes in hearing variables in the low-risk group in OOPS. The mean OOPS score was greater in patients with success than those with non-success. Otorrhea, ossicle status, and status of mucosa as variables in both indices were associated with success. The type of mastoidectomy as a variable in OOPS alone was associated with success. Absence of hypertension, presence of ossiculoplasty, and use of incus as ossiculoplasty material were associated with poor success rate. Conclusion Compared with MERI, the OOPS index was more closely associated with the hearing outcomes, which may be due to the extent of inflammation in the OOPS index.

scholarly journals A retrospective study on middle ear risk indices in analysing the post-operative outcome following tympanoplasty

2021 ◽  
Vol 7 (9) ◽  
pp. 1468
Author(s):  
Risvana P. P. ◽  
Mubeena K.
Keyword(s):  
Retrospective Study ◽  
Otitis Media ◽  
Middle Ear ◽  
Risk Index ◽  
Chronic Otitis Media ◽  
Favourable Outcome ◽  
Middle Ear Mucosa ◽  
Gap Closure ◽  
Risk Indices ◽  
Outcome Of Surgery

<p class="abstract"><strong>Background:</strong> Chronic otitis media is a highly prevalent disease of middle ear. As tympanoplasty plays an important role in management of otitis media it is important to predict the outcome of surgery and give proper counselling to the patient. The objective of this study was to evaluate the effectiveness of Middle ear risk index (MERI) in determining postoperative graft uptake and postoperative air bone gap closure following tympanoplasty.</p><p class="abstract"><strong>Methods:</strong> This was a retrospective study conducted to find the correlation between MERI and the result of tympanoplasty outcome and post-operative hearing gain. Ninety-six subjects who underwent tympanoplasty for chronic otitis media were included in the study. MERI score was calculated and was compared with postoperative graft uptake and audiogram.  </p><p class="abstract"><strong>Results:</strong> In this study there was no statistical difference in graft uptake between the MERI categories. There was statistically significant decrease in postoperative air bone gap closure in both mild and moderate categories. Other prognostic factors associated with a favourable outcome were healthy middle ear mucosa and absence of smoking.</p><p class="abstract"><strong>Conclusions:</strong> MERI did not have a direct impact on the outcome of surgery in terms of graft uptake and hearing results. However certain factors like Belluci’s criteria and smoking had an impact on the outcome. Hence MERI can be used for pre-operative counselling of the patients.</p>

scholarly journals Correlation Between MERI and Hearing After Tympanoplasty

2017 ◽  
Vol 13 (2) ◽  
pp. 6-9 ◽  
Author(s):  
Anshu Sharma ◽  
R. K. Saxena ◽  
Lok Ram Verma ◽  
Shama Bhandari
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Analytical Study ◽  
Risk Index ◽  
Chronic Otitis Media ◽  
Hearing Improvement ◽  
Hearing Gain ◽  
Different Types ◽  
The Mean ◽  
The Impact

Background: Chronic otitis media is otological challenge in the developing countries it is particularly single most common cause of hearing impairement.Objective: The objective of this study was to observe the impact of prognostic factor middle ear risk index on hearing of patients undergoing tympanoplasty for chronic otitis media.Methods: This was a prospective analytical study conducted in 50 patients planned for tympanoplasty for chronic otitis media and evaluation done by MERI (Middle Ear Risk Index) and pure tone audiometry.Results: This study shows that most of the patients had mild MERI (64%), followed by severe MERI (20%) and then moderate MERI (16%). The mean preoperative PTA average was 44.34 dB (SD 8.01 dB) for patient with mild MERI, 44.75 dB (SD 5.87 dB) for patient with moderate MERI, and 54.9 dB (SD 14.05 dB) for patient with severe MERI and the mean preoperative A-B gap was 37.36 dB (SD 5.73 dB). Post operatively for mild MERI mean hearing gain is 12-14dB, for moderate MERI mean hearing gain is 10-13dB and for severe MERI mean hearing gain is 10-13dB and post operative mean A-B gap was improved by 10-11dB. There is a statistically significant hearing improvement in A-B gap with different types of MERI.Conclusion: MERI scoring is useful for predicating the outcome of hearing after tympanoplasty.JNGMC Vol. 13 No. 2 December 2015, Page: 6-9

Chronic Secretory Otitis Media: Effects of Surgical Management

1989 ◽  
Vol 98 (1_suppl2) ◽  
pp. 2-32 ◽  
Author(s):  
George A. Gates ◽  
J. C. Cooper ◽  
Christine A. Avery ◽  
Thomas J. Prihoda
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Surgical Management ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media ◽  
Secretory Otitis Media ◽  
Tympanostomy Tubes ◽  
The Mean ◽  
First Recurrence

To study the effectiveness of adenoidectomy and tympanostomy tubes in the treatment of chronic otitis media with effusion, we randomly assigned 578 4- to 8-year-old children to receive one of the following: Bilateral myringotomy and no additional treatment (group 1), tympanostomy tubes (group 2), adenoidectomy and myringotomy (group 3), or adenoidectomy and tympanostomy tubes (group 4). The 491 who accepted surgical treatment were evaluated at 6-week intervals for up to 2 years. Treatment effect was assessed by four main outcomes: Time with effusion, time with hearing loss, time to first recurrence of effusion, and number of surgical re-treatments. For the groups (in order), the mean percent of time with any effusion in either ear was 49, 35, 30, 26 (p < .0001); the mean percent of time with hearing thresholds 20 dB or greater was 19, 10, 8, and 7 (p < .0001) in the better ear; and 38, 30, 22 and 22 in the worse ear (p < .0001); the median number of days to first recurrence was 54, 222, 92, and 240 (p < .0001); and the number of surgical re-treatments was 66, 36, 17, and 17 (p < .0001). The most notable adverse sequela, purulent otorrhea, occurred in 22%, 29%, 11%, and 24% of the patients assigned to groups 1 through 4, respectively (p < .001). In severely affected children who have chronic otitis media with effusion resistant to medical therapy, adenoidectomy is an effective treatment. Adenoidectomy plus bilateral myringotomy lowered posttreatment morbidity more than tympanostomy tubes alone and to the same degree as did adenoidectomy and tympanostomy tubes. Adenoidectomy appears to modify the underlying pathophysiology of chronic otitis media with effusion. This effect is independent of the preoperative size of the adenoid. Tympanostomy tube drainage and ventilation of the middle ear provide adequate palliation so long as the tubes remain in place and functioning. We recommend that adenoidectomy be considered in the initial surgical management of 4- to 8-year-old children with hearing loss due to chronic secretory otitis media that is refractory to medical management and, further, that the size of the adenoid not be used as a criterion for adenoidectomy. Concomitant bilateral myringotomy with suction aspiration of the middle ear contents also should be done, with or without placement of tympanostomy tubes at the discretion of the surgeon.

scholarly journals A retrospective study on middle ear risk indices in analysing the postoperative outcome following tympanoplasty

2019 ◽  
Vol 5 (5) ◽  
pp. 1234
Author(s):  
P. Vignadutt ◽  
Ali Shaik
Keyword(s):  
Middle Ear ◽  
Risk Group ◽  
Risk Index ◽  
Postoperative Outcome ◽  
Medical Sciences ◽  
Risk Indices ◽  
Prevalent Disease ◽  
Patient Groups ◽  
Middle Ear Disease ◽  
Severity Of The Disease

<p class="abstract"><strong>Background:</strong> Otitis media is an important and a highly prevalent disease of the middle ear and poses serious health problem worldwide especially in developing countries where large percentage of the population lack specialized medical care. A normally functioning eustachian tube is an equally essential physiologic requirement for a healthy middle ear and normal hearing. In this study we have used the middle ear risk index (MERI) developed by Kartush which generates a numeric indicator of the severity of the middle ear disease to stratify patient groups according to the severity of the disease and to evaluate the efficiency of MERI score in predicting the outcome of tympanoplasty.</p><p class="abstract"><strong>Methods:</strong> Patients who came and got operated for tympanoplasty to the ENT Department in Konaseema Institute of Medical Sciences and RF, Amalapuram during the study period of February 2017 to February 2018.  </p><p class="abstract"><strong>Results:</strong> In this study graft was accepted in 22 patients (88%) and rejected in 3 (12%) patients. In patients in the mild MERI risk group n=22, graft was accepted in 21 (95%) patients and rejected in 1 patient (5%). Patient had a residual perforation. In patients in the moderate MERI risk group n=2, graft was accepted in 1 (50%) patients and rejected in 1 patient (50%).In severe risk group none of the grafts were accepted (100%).</p><p><strong>Conclusions:</strong> MERI index is in fact a very useful and honest predictor of the graft uptake and audiological gain in patients undergoing tympanoplasty surgeries for CSOM. Lower the MERI index better the outcome. Positive Belluci criteria were also found to be inversely associated with the graft uptake.</p>

Mechanism of Hearing Loss in Irradiated Ears: A Long-Term Longitudinal Study

2001 ◽  
Vol 110 (10) ◽  
pp. 904-906 ◽  
Author(s):  
Yi-Ho Young ◽  
Ying-Chih Lu
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Bone Conduction ◽  
Chronic Otitis Media ◽  
Pure Tone Audiometry ◽  
Tube Function ◽  
The Mean ◽  
Air Conduction

A 10-year longitudinal follow-up study of hearing was conducted in patients with nasopharyngeal carcinoma (NPC) in order to elucidate the mechanism of hearing loss in irradiated ears. Ten NPC patients were subjected to a battery of audiological tests before irradiation and 6 months, 5 years, and 10 years after irradiation. The tests included pure tone audiometry, tympanometry, eustachian tube function testing, and myringotomy to confirm middle ear effusion. The prevalences of otitis media with effusion (OME) were 25%, 25%, 40%, and 25% at the 4 testing periods described above, respectively. The prevalences of chronic otitis media were 0%, 0%, 15%, and 25%, respectively. In myringotomized ears (n = 17), the mean hearing levels for both air conduction and bone conduction were preserved from the preirradiation period to 10 years after irradiation. In contrast, in grommeted ears (n = 3), the mean hearing levels for both air conduction and bone conduction deteriorated progressively from the preirradiation period to 10 years after irradiation. We conclude that hearing can be preserved in NPC patients 10 years after irradiation if middle ear inflammation is well controlled. We do not recommend grommet insertion in irradiated NPC patients with OME, as it may result in persistent otorrhea and hearing deterioration.

Long-term middle-ear ventilation with subannular tubes

2010 ◽  
Vol 124 (9) ◽  
pp. 945-949 ◽  
Author(s):  
A Daudia ◽  
S Yelavich ◽  
P J D Dawes
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Case Series ◽  
Chronic Otitis Media ◽  
Tympanic Membrane Perforation ◽  
Retrospective Case ◽  
The Mean

AbstractObjective:Long-term tympanostomy tubes are associated with a significant rate of complications, particularly persistent perforation. We describe the outcomes of 57 subannular ventilation tube insertions in 45 consecutive patients.Design:Retrospective case series.Subjects:We studied 45 consecutive patients with chronic otitis media with effusion and hearing loss (n = 54 cases), associated with adhesive otitis media (n = 7), tympanic membrane retraction (n = 17) and tympanic membrane perforation (n = 3). The mean follow up was 48 months (range, nine to 95 months).Results:The mean duration of ventilation for tubes still in situ was 22 months (range, one to 76 months; n = 29), and for tubes which extruded or were removed 23 months (range, one to 85 months; n = 28). The mean improvement in air–bone gap was 14 dB (range, −14 to 35 dB). Complications included blockage (16 per cent), perforation after extrusion (9 per cent), granulation (5 per cent) and infection (4 per cent).Conclusion:Subannular ventilation tubes provide an effective option for management of intractable middle-ear effusion and eustachian tube dysfunction.

Ossicular chain reconstruction improves bone conduction threshold in chronic otitis media

2008 ◽  
Vol 122 (4) ◽  
pp. 351-356 ◽  
Author(s):  
H-S Lee ◽  
S-D Hong ◽  
S H Hong ◽  
Y-S Cho ◽  
W-H Chung
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Bone Conduction ◽  
Chronic Otitis Media ◽  
Ossicular Chain ◽  
Bone Conduction Threshold ◽  
Ossicular Chain Reconstruction ◽  
Duration Of Disease ◽  
The Mean ◽  
Conductive Mechanism

AbstractThis study aimed to assess the elevation of bone conduction threshold in patients with chronic otitis media and to investigate the mechanism of this phenomenon. One hundred and six patients with unilateral chronic otitis media who had undergone a tympanomastoidectomy were reviewed retrospectively. The differences in the bone conduction thresholds between the diseased and normal sides were assessed and compared according to the duration of the disease and the presence of cholesteatoma. Post-operative changes in the bone conduction threshold were also assessed. The mean bone conduction thresholds were significantly elevated on the diseased side, ranging from 3.4 to 11.6 dB across frequencies, with a maximal elevation at 2000 Hz. The duration of disease and the presence of cholesteatoma did not affect the degree of the bone conduction elevation. After ossicular reconstruction, bone conduction thresholds improved significantly at all frequencies, with the greatest improvement being observed at 2000 Hz. These results suggest that the elevation in the bone conduction threshold in chronic otitis media is mainly caused by a change in the conductive mechanism in the middle ear.

Comparison of the Aditus ad Antrum Diameter on CT between Patients with Chronic Otitis Media and Healthy Individuals

2019 ◽  
Vol 15 (10) ◽  
pp. 990-993 ◽  
Author(s):  
Elif Gündoğdu ◽  
Uğur Toprak
Keyword(s):  
Computed Tomography ◽  
Otitis Media ◽  
Middle Ear ◽  
Healthy Subjects ◽  
Normal Values ◽  
Chronic Otitis Media ◽  
Healthy Individuals ◽  
Inner Diameter ◽  
Male Patients ◽  
The Right

Background: The middle ear cavity is ventilated through the aditus ad antrum. Aditus blockage contributes to the pathology of otitis media. Objective: To determine the normal values of the aditus ad antrum diameter on computed tomography and to investigate its relationship with chronic otitis media and related pathologies (tympanosclerosis and myringosclerosis). Methods: The temporal CT images of 162 individuals were evaluated retrospectively. In the axial sections, the inner diameter of the aditus was measured at the narrowest point at the cortex. The differences in diameter were compared between diseased and healthy ears. Results: In healthy individuals, the diameter was narrower in women. There was no difference between the right and left ears in healthy subjects. No correlation was found between age and diameter. In male patients with myringosclerosis, the diameter was slightly narrower on both sides but more marked on the left. In female patients with myringosclerosis, the diameter in both ears was slightly narrower. In cases of otitis media and tympanosclerosis, the diameter was less than that of healthy individuals, despite the lack of statistically significant result in all cases. Conclusion: The aditus ad antrum was narrower in diseased ears, indicating that a blocked aditus may contribute to the development of otitis media, as well as mucosal diseases.

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