scholarly journals Comparison of efficacy of myringoplasty in dry and wet ears in chronic otitis media of tubotympanic type

2017 ◽  
Vol 3 (3) ◽  
pp. 705 ◽  
Author(s):  
Yogeshwar Chandrashekar ◽  
Ravishankar Chandrashekar
Keyword(s):  
Otitis Media ◽  
Statistical Significance ◽  
Chronic Otitis Media ◽  
Pure Tone Audiometry ◽  
Inflammatory Cells ◽  
P Value ◽  
Hearing Improvement ◽  
Female Ratio ◽  
Fascia Graft ◽  
A Prospective Study

<p class="abstract"><strong>Background:</strong> The objective of the study was to compare the outcome of myringoplasty in dry and wet ears in tubotympanic type of chronic otitis media (COM) with respect to graft uptake and hearing improvement.</p><p class="abstract"><strong>Methods:</strong> This is a prospective study done in department of ENT Bangalore Medical College and Research Institute during the study period of November 2014 to May 2016, wherein a total of 60 patients of tubotympanic type COM with 30 cases each of dry and wet ears, aged 15-60 years were included. The hearing impairment was assessed and recorded by pure tone audiometry (PTA). After obtaining informed written consent the patients underwent myringoplasty (temporalis fascia graft, underlay technique). Microbiological examination of discharge in wet ears was done and histopathology of the excised remnant TM analyzed in both groups. Both groups of patients were followed up for 3 months and assessed for graft uptake and hearing improvement. PTA was repeated at 3 months postoperatively.  </p><p class="abstract"><strong>Results:</strong> Our study included 60 patients of tubotympanic type of COM with 30 cases each with dry and wet ears who underwent myringoplasty. Majority of our patients were in second decade in both the groups. There was slight female preponderance in our study with male to female ratio of 0.93:1. Discharge from ears in wet ears was mucoid in consistency and were culture negative. Histopathology of excised remnant TM in wet ears revealed evidence of inflammatory cells and vascularization within stroma of fibroblasts while these were absent in dry ear cases. The overall successful graft uptake following myringoplasty was 88.3% with 86.7% for wet ears and 90% for dry ears with no statistical significance (p value of 0.688&gt;0.05) between the two groups. With respect to hearing improvement post-operatively there was significant hearing improvement in both the groups when compared to preoperative hearing with a mean hearing gain (dB) of 3.43±2.81 in wet ear cases to 3.85±3.05 in dry ear cases, but when compared between the two groups, there was no significant statistical difference (p value of 0.582&gt;0.05).</p><p><strong>Conclusions:</strong> The outcome is equally good for myringoplasty in dry and wet ears in tubotympanic type of chronic otitis media with respect to graft uptake and hearing improvement. </p>

scholarly journals Evaluation of Graft Uptake and Hearing Assessment after Palisade Myringoplasty

2018 ◽  
Vol 56 (212) ◽  
pp. 770-773 ◽  
Author(s):  
Poonam KC
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Uptake Rate ◽  
Pure Tone ◽  
Statistical Significance ◽  
Chronic Otitis Media ◽  
Pure Tone Audiometry ◽  
Long Term Results ◽  
Hearing Improvement ◽  
Hearing Gain

Introduction: Cartilage as a graft for closure of tympanic membrane has got superior benefits than other usual grafts (temporalis fascia and perichondrium). Cartilage supported myringoplasty with palisade technique has good result of graft uptake rate, even under difficult conditions. This technique brings very good functional and better long-term results. This study is done to assess graft uptake rate and hearing improvement after myringoplasty with cartilage palisade technique. Methods: It is a descriptive, hospital based observational study done at Manipal Teaching Hospital, Pokhara between 2014-2017. A total of 45 patients aged between 13 years and 44 years diagnosed with chronic otitis media-mucosal were taken. Pure tone audiometry was done before and six months after surgery. Graft uptake and Post-operative hearing gain was evaluated after six months. Statistical analysis was done by Statistical Package for Social Sciences version 16.0. Statistical significance was set at P<0.05. Results: Graft uptake rate was 41 (91.1%). The mean pre-and post-operative pure tone average were 26.88dB and 8.44dB respectively. The post-operative hearing gain was 18.36dB. Hearing improvement after surgery was found to be statistically highly significant with P<0.001. Conclusions: Cartilage supported myringoplasty using palisade technique is preferred for chronic otitis media-mucosal with large and sub-total tympanic membrane perforation.

scholarly journals Assessment of the outcome of myringoplasty with cortical mastoidectomy in dry and wet mucosal type of chronic otitis media

2020 ◽  
Vol 6 (11) ◽  
pp. 2001
Author(s):  
Sreeshma Balan ◽  
Prakash M. D.
Keyword(s):  
Success Rate ◽  
Otitis Media ◽  
Statistical Significance ◽  
Chronic Otitis Media ◽  
P Value ◽  
Hearing Improvement ◽  
Cortical Mastoidectomy ◽  
Significant Difference ◽  
Group A ◽  
Group B

<p class="abstract"><strong>Background:</strong> Chronic otitis media (COM) is an inflammatory process in the middle ear space that results in long-term changes in the tympanic membrane including atelectasis, dimeric-membrane formation, perforation, tympanosclerosis, retraction pocket or cholesteatoma. COM can be classified into healed, inactive (mucosal or squamosal), active (mucosal or squamosal). Myringoplasty is tympanoplasty without ossicular reconstruction. Cortical mastoidectomy is usually accompanied by tympanoplasty. Aim was to assess and compare the efficacy of myringoplasty with cortical mastoidectomy in dry and wet mucosal type of COM, in terms of graft uptake and hearing improvement.</p><p class="abstract"><strong>Methods:</strong> A prospective study, where 30 patients each of wet and dry mucosal-type COM were included. Patients underwent myringoplasty with cortical mastoidectomy. All were followed up for 6 months, both the groups were statistically compared.  </p><p class="abstract"><strong>Results:</strong> In our study, mean age of patients in group A (wet COM) was 34.13 years and group B (dry COM) was 33.36 years. Group A had success rate of 90% and group B had success rate of 86.6%. There was no statistical significance (p value- 0.53) on comparing both groups with respect to graft uptake. There was significant hearing improvement post-operatively in both the groups (p&lt;0.05). However, there was no significant difference between the groups (p value- 0.66). This shows that presence of discharge at the time of surgery does not interfere with the results of cortical mastoidectomy with myringoplasty.</p><p class="abstract"><strong>Conclusions:</strong> We conclude that, there is good outcome in both wet and dry COM following myringoplasty with cortical mastoidectomy with respect to graft uptake and hearing improvement.</p>

scholarly journals Myringoplasty in wet and dry ears: an observational study in a tertiary care center

2021 ◽  
Author(s):  
S. Umamaheswara Rao ◽  
K. Samatha Reddy ◽  
Siva Subba Rao Pakanati ◽  
S. Chandramouli
Keyword(s):  
Observational Study ◽  
Otitis Media ◽  
Care Center ◽  
Tertiary Care ◽  
Hearing Threshold ◽  
Chronic Otitis Media ◽  
Hearing Improvement ◽  
Female Ratio ◽  
Medical College ◽  
Maximum Improvement

<p class="abstract"><strong>Background: </strong>Chronic otitis media is the most common cause of hearing impairment in the developing countries with serious effects. The aim of the study was to compare the outcome of myringoplasty in dry and wet ears in tubo-tympanic type of chronic otitis media (COM) with respect to graft uptake and hearing improvement.</p><p class="abstract"><strong>Methods:</strong> This is an observational study done in the department of ENT, Mamata medical college, Khammam, during the study period of September 2019 to February 2021 on 40 patients of tubo-tympanic type COM. On simple random basis selected patients underwent myringoplasty by underlay technique. All patients were evaluated during post-operative follow-up.</p><p class="abstract"><strong>Results:</strong> In our study, majority of patients were in the age group of 26 to 45 years with slight female preponderance, with male to female ratio (0.73:1). In our study, the successful graft uptake was seen 90% in dry ears and 85% in wet ears, which seems to be not significant in difference. With respect to hearing improvement, post-operatively there was significant improvement in both the groups, when compared to pre-operative hearing. The maximum improvement in average hearing threshold after surgery, in dry ears with large perforation (12.66dB) and in wet ears with small central perforation (12.44dB) was almost equal.</p><p><strong>Conclusions: </strong>In this study, the success rate of graft uptake and hearing improvement is found almost equal in dry and wet ears by using underlay technique of myringoplasty. </p>

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 Tympanoplasty for Wet and Dry Perforation: A Prospective Comparative Study

2021 ◽  
Vol 28 (3) ◽  
pp. 260-265
Author(s):  
Amit Bikram Maiti ◽  
Rupam Sinha
Keyword(s):  
Prospective Study ◽  
Comparative Evaluation ◽  
Statistical Significance ◽  
Chronic Otitis Media ◽  
Tympanic Membrane Perforation ◽  
Hearing Improvement ◽  
Mucosal Disease ◽  
Membrane Perforation ◽  
Prospective Comparative Study ◽  
A Prospective Study

Introduction Two types of surgical procedures are performed for the treatment of Chronic otitis media (COM) mucosal disease, namely myringoplasty and tympanoplasty. In the present study, an objective, comparative evaluation between the outcomes of tympanoplasty, performed in the ‘wet ear’ and the ‘dry (non- discharging) ear’ has been undertaken. Materials and Methods A prospective study was conducted in a peripheral referral institute over a period of 37 months    wherein a total of 105 patients with tympanic membrane perforation were selected, amongst which 56 patients had moist ear and 49 patients had dry ear. All of the patients underwent tympanoplasty by underlay technique. Final results were analyzed 12 months post operatively. Results In the wet ear group amongst 56 patients, 51 patients had successful graft uptake (91.07%). In dry          ear group, among 49 patients, successful graft uptake was seen in 44 cases (89.79%). In the wet ear group 50 out of 56 patients had hearing improvement (89.28%). In dry ear group 44 out of 49 patients had hearing improvement (89.79%). Statistically significant results were obtained postoperatively in each group; however, inter group analyses showed no statistical significance. Conclusion Success rate of tympanoplasty does not depend upon the wet or dry state of middle ear at the time of surgery.

scholarly journals Endoscopic myringoplasty: outcome and hearing gain in inactive mucosal chronic otitis media

2019 ◽  
Vol 5 (2) ◽  
pp. 330
Author(s):  
B. T. Subramanya ◽  
S. Lohith ◽  
B. Sphoorthi
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Hearing Improvement ◽  
Suppurative Otitis Media ◽  
Hearing Gain ◽  
Endoscopic Myringoplasty ◽  
A Prospective Study ◽  
Postoperative Scar ◽  
Middle Ear Cleft

<p class="abstract"><strong>Background:</strong> Chronic otitis media is an inflammatory process in the middle ear cleft that poses serious health problem in developing countries. Myringoplasty is a common otological procedure to reconstruct the tympanic membrane to prevent recurrent otorrhea, and restore sound-conducting mechanism. The use of rigid endoscope in transcanal myringoplasty has significant advantage as it provides magnified, close up as well as wide angle view, less morbidity and early postoperative wound healing with better cosmetic results without compromising success rate and postoperative hearing gain. The aims and objectives of the study were to analyze the results of endoscopic transcanal interlay myringoplasty, in terms of graft uptake and hearing improvement in cases of chronic suppurative otitis media with inactive mucosal disease with central perforation.</p><p class="abstract"><strong>Methods:</strong> This is a prospective study conducted from January 2016 to August 2018 in 30 patients of inactive mucosal chronic otitis media (COM). All patients underwent transcanal endoscopic interlay myringoplasty and patients were called for regular follow up for 12 weeks and results were statistically analysed.  </p><p class="abstract"><strong>Results:</strong> The graft uptake rate in the present study was found to be 93.33%. Pre operatively mean air bone gap (ABG) was 27.33 dB and post operatively after 12 weeks mean air bone gap improved to 10.5 dB. Mean ABG gain was 16.33%.</p><p class="abstract"><strong>Conclusions:</strong> Endoscopic transcanal interlay myringoplasty with superiorly based TM flap is an effective technique over conventional microscopic technique in terms of graft uptake, hearing improvement, better postoperative scar and less morbidity in cases of inactive mucosal COM.</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.

scholarly journals Correlation Between Adenoid Hypertrophy, Tympanometry Findings, and Viscosity of Middle Ear Fluid in Chronic Otitis Media With Effusion, Southern Oman

2019 ◽  
pp. 014556131987543
Author(s):  
Hazem M. Abdel Tawab ◽  
Salim M. Sloma Tabook
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media ◽  
P Value ◽  
Adenoid Hypertrophy ◽  
Significant Relation ◽  
Adenoid Tissue ◽  
Middle Ear Fluid ◽  
A Prospective Study

Otitis media with effusion is a common cause of diminished hearing in children younger than 12 years. Hypertrophy of adenoids is one of the commonest etiologies of this condition. It has been mentioned that with increased size of the adenoid tissue, the more likely the incidence of fluid in the middle ear. The aim of this study was to find whether there is a correlation between adenoid size, tympanometric findings, and type of fluid in the middle ear irrespective of disease duration. This is a prospective study done on 100 pediatric patients (12 years and less) presented with chronic otitis media with effusion (COME) and adenoid hypertrophy from July 2015 till July 2017. Cases with tympanometry evidence of COME (B, Cs) and adenoid hypertrophy seen by nasal endoscopy were included. Adenoid size was graded and correlated with the type of tympanometry and type of fluid in the middle ear. Sixty male children and 40 female children were involved. Age ranged from 3 to 12 years with a mean of 7.19 ± 2.489 years. Highly significant relation existed between grade 4 adenoid hypertrophy and mucoid nature of middle ear fluid ( P value = .000). There is a highly significant relation between adenoid hypertrophy grade Ⅳ and type B tympanometry. There is a highly significant relation between adenoid size and nature of middle ear fluid irrespective of the duration of complaints, where grade Ⅳ adenoid hypertrophy showed more increase in middle ear effusion viscosity making adenoid size a very important predictor for the tympanometry type and the nature of the fluid in the middle ear.

scholarly journals A prospective study of sinonasal and nasopharyngeal pathology in chronic otitis media

2018 ◽  
Vol 4 (5) ◽  
pp. 1263
Author(s):  
Sajitha K. B. ◽  
Binu Thomas ◽  
Ihsan A. T.
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Mastoid Cavity ◽  
P Value ◽  
Ear Surgery ◽  
Bacteriological Study ◽  
Comprehensive Management ◽  
Diagnostic Profile ◽  
A Prospective Study ◽  
The Comparative Study

<p class="abstract"><strong>Background:</strong> Chronic otitis media (COM) implies a permanent abnormality in the tympanic membrane characterized by irreversible changes in the mucosa of middle ear and mastoid cavity. Diseases of the nose and para nasal sinuses have been implicated in the development of the disease. Hence the present study aims at identifying the risk factors involved and the importance of its management in treating the disease. The objective was to study the correlation between COM and Sino nasal and nasopharyngeal pathology.</p><p class="abstract"><strong>Methods:</strong> A total of 100 patients with chronic otitis media were included in the study. A Detailed history and clinical examination was done using a pre-prepared questionnaire.  Diagnostic nasal endoscopy was done in all cases to assess the nasal cavity and nasopharynx along with bacteriological study of ear and corresponding side of nasopharynx.  </p><p class="abstract"><strong>Results:</strong> Symptomatic, clinical and diagnostic profile proved the evidence of sinonasal pathology in 82% of patients with COM. The comparative study of the microbiological flora of both ear and corresponding side of nasopharynx showed 77 % of ear swabs and 91% of nasopharyngeal swabs to be sterile. The results were statistically significant with a p value of 0.003.</p><p class="abstract"><strong>Conclusions:</strong> This study emphasises on a thorough evaluation of nose and paranasal sinuses in all cases of COM for comprehensive management of the disease. Its detection and management is equally important as the ear surgery per se.</p>

Hearing Status After Cartilage Augmented Type III Tympanoplasty: In Chronic Otitis Media Squamous Type

2021 ◽  
Vol 18 (2) ◽  
pp. 27-30
Author(s):  
Lok Ram Verma ◽  
Dhundi Raj Paudel
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Effective Area ◽  
Canal Wall ◽  
Hearing Improvement ◽  
Type Iii ◽  
Hearing Status ◽  
Fascia Graft ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy

Introduction: Tympanoplasty is typically performed in conjunction with a canal wall down mastoidectomy in patient with Chronic Otitis Media Squamous. The results from experimental and clinical studies of the type III stapes columellar reconstruction have shown that interposing a disk of cartilage between the graft and the stapes head improves hearing in the lower frequencies by 5 to 10 dB. They hypothesize that the cartilage acts to increase the “effective” area of the graft that is coupled to the stapes, which leads to an increase in the middle ear gain of the reconstructed ear. Aims: To assess the hearing improvement after cartilage augmented Type III Tympanoplasty in chronic otitis media squamous disease. Methods: This study was conducted in 44 patients with Chronic Otitis Media squamous in the patients attending the department of Otorhinolaryngology in NGMC teaching hospital from November 2018 to March 2020. Canal Wall Down mastoidectomy with cartilage augmented type III Tympanoplasty and was done. Augmentation was done with thin 3-4 mm conchal cartilage interposed between stapes and Temporalis fascia graft. Results: There were 11(25%) male and 33(75%) female, with mean age of 29.48 years, ranging from minimum of 15 years to maximum 56 years. The preoperative mean A–B gap was 21.82 and postoperatively means AB gap was 12.20 dB with overall AB gap gain was 9.64 dB. Conclusion: Significant hearing improvement is seen in Canal Wall Down mastoidectomy Chronic Otitis Media squamous after cartilage augmented type III tympanoplasty.

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