scholarly journals A study of surgical outcomes of myringoplasty in active and inactive ears

2017 ◽  
Vol 4 (1) ◽  
pp. 148
Author(s):  
Vasim Ismail Patel ◽  
N. H. Kulkarni ◽  
Jyothi A. C. ◽  
ShriKrishna B. H.
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Group Differences ◽  
Hearing Improvement ◽  
Ear Surgery ◽  
Hearing Gain ◽  
Gain Rate ◽  
Graft Take ◽  
Cortical Mastoidectomy ◽  
Widespread Belief

<p class="abstract"><strong>Background:</strong> Chronic otitis media (COM) can present with inactive (dry) and active (wet) 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 active ears is decidedly inferior. Hence the present study is intended to find the outcome of ear surgeries in inactive and active ear with objective to find the incidence of graft uptake and hearing improvement in both the groups.</p><p class="abstract"><strong>Methods:</strong> A total of 50 active ear (with mucoid discharge) and 52 inactive ears (not discharging at least 3 month before surgery) with mucosal chronic otitis media underwent myringoplasty with cortical mastoidectomy. Graft take and hearing gain rates 3 and 6 months after surgery were calculated for both groups and compared.  </p><p class="abstract"><strong>Results:</strong> The graft take rate was 90% for the active ear group and 94% for the inactive ear group. The hearing gain rate was 90% for the active ear group and 94% for the inactive ear group. Differences were found to be statistically insignificant for both graft intake (p=0.461) and hearing gain (p=0.543).</p><p><strong>Conclusions:</strong> The success of myringoplasty is not adversely affected by the presence of mucoid ear discharge at time of surgery, and outcomes are comparable to those of the opration done for inactive ears. </p>

scholarly journals Cortical Mastoidectomy with Tympanoplasty in the Management of Chronic Mucosal Otitis Media

KYAMC Journal ◽  
2020 ◽  
Vol 11 (2) ◽  
pp. 91-95
Author(s):  
Muntasir Mahbub ◽  
Abdullah Al Zobair ◽  
Nabila Mannan ◽  
Md Mahmudul Haque ◽  
Khabir Uddin Ahmed
Keyword(s):  
Medical Treatment ◽  
Otitis Media ◽  
Chronic Otitis Media ◽  
Female Ratio ◽  
Hearing Status ◽  
Graft Take ◽  
Cortical Mastoidectomy ◽  
Treatment Objective ◽  
Male To Female ◽  
Study Inclusion

Background: Cortical mastoidectomy with tympanoplasty is considered the standard of treatment in case of active mucosal chronic otitis media, refractory to medical treatment. Objective: Aim for this study was to find out the efficacy of cortical mastoidectomy with tympanoplasty in the management of chronic mucosal otitis media. Materials and Methods: This is an observational study conducted from January 2016 to July 2016. Total 50 patients were included in this study. Inclusion criteria was diagnosed cases of mucosal chronic otitis media with persistent ear discharge, adequate medical treatment, age between 15-60 years of both sexes. All the patients underwent cortical mastoidectomy with tympanoplasty, and patients were followed up to 12 weeks to evaluate graft take rate and compare pre-operative and post-operative hearing status. Results: In this study male to female ratio was 1.17:1. Mean age of study group was 30.66 ( 9.62) years. Graft uptake was successful in 43 (87%) and in 07 (14%) graft didn't take. Graft take rate was highest in 15-30 years age group. Mean preoperative and post-operative air bone gap were 28.45 (7.69) dB and 25.30 ( 8.5) dB respectively. Conclusion: Cortical mastoidectomy with tympanoplasty shows good outcome in aspects of disease clearance and graft uptake success in chronic mucosal otitis media. Although hearing gain occurs in most cases, it is rather modest. KYAMC Journal Vol. 11, No.-2, July 2020, Page 91-95

Stapedectomy following tympanoplasty

2001 ◽  
Vol 115 (6) ◽  
pp. 444-446 ◽  
Author(s):  
Leonard Berenholz ◽  
William Lippy ◽  
John Burkey ◽  
Arnold Schuring ◽  
Franklin Rizer
Keyword(s):  
Otitis Media ◽  
Pure Tone ◽  
Chronic Otitis Media ◽  
Rare Occurrence ◽  
Hearing Improvement ◽  
Hearing Gain ◽  
Pure Tone Average ◽  
History Of

The aim of this study was to evaluate the success of stapedectomy in patients who have previously had a tympanoplasty because of chronic otitis media (COM). Fourteen patients from a private otology practice had undergone tympanoplasty for COM and subsequently underwent stapedectomy. Measurements were taken of the air-bone gap (ABG) closure and pure tone average (PTA) which showed hearing improvement. Patients had a mean 36.9 dB PTA hearing gain with 79 per cent closing the ABG to within 20 dB. The need for stapedectomy alone is a rare occurrence for patients with a history of COM requiring a tympanoplasty. Hearing improvement following stapedectomy in these cases was significant, although somewhat less than following traditional stapedectomy in otosclerosis alone.

Cortical mastoidectomy in quiescent, tubotympanic, chronic otitis media: is it routinely necessary?

2008 ◽  
Vol 123 (4) ◽  
pp. 383-390 ◽  
Author(s):  
K V Bhat ◽  
K Naseeruddin ◽  
U S Nagalotimath ◽  
P R Kumar ◽  
J S Hegde
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Controlled Study ◽  
Hearing Improvement ◽  
Tertiary Referral Hospital ◽  
Suppurative Otitis Media ◽  
Disease Eradication ◽  
Cortical Mastoidectomy ◽  
Randomised Controlled Study ◽  
Randomised Controlled

AbstractObjective:This study aimed to compare outcomes for mastoidotympanoplasty and for tympanoplasty alone in cases of quiescent, tubotympanic, chronic, suppurative otitis media.Study design:Single-blinded, randomised, controlled study within a tertiary referral hospital.Methods:Sixty-eight cases were randomly allocated into two groups. In group one, 35 ears underwent type one tympanoplasty along with cortical mastoidectomy. In group two, 33 ears underwent type one tympanoplasty alone. Outcome measures were as follows: perforation closure and graft uptake, hearing improvement, disease eradication, and post-operative complications.Results:There were no statistically significant differences in hearing improvement, tympanic perforation closure, graft uptake or disease eradication, comparing the two groups at three and six months post-operatively.Conclusion:Mastoidotympanoplasty was not found to be superior to tympanoplasty alone over a short term follow-up period. Hence, it may not be necessary to undertake routine mastoid exploration at this stage of disease.

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 effect of preserved stapedial superstructure on hearing improvement

2019 ◽  
Vol 73 (6) ◽  
pp. 1-5
Author(s):  
Aleksandra Boroń ◽  
Agnieszka Wiatr ◽  
Jacek Składzień ◽  
Maciej Wiatr
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Ossicular Chain ◽  
The Other ◽  
Middle Ear Surgery ◽  
Reconstruction Method ◽  
Hearing Improvement ◽  
Ear Surgery ◽  
Extent Of Damage

Introduction: Ossiculoplasty can be carried out in a number of ways, depending on the anatomical and functional conditions encountered during otosurgery and the experience of a given centre. The extent of damage to the ossicular chain determines the reconstruction method. Aim: The objective of the study was to analyse treatment effects in terms of postoperative hearing improvement in patients with chronic otitis media, with a particular emphasis on stapedial superstructure preservation. Material and method: The records of 294 consecutive patients undergoing their first ENT surgery due to chronic otitis media at the Department of Otolaryngology of Collegium Medicum, Jagiellonian University of Kraków in 2009–2013 were analysed. In order to assess the role of preserved stapedial superstructure, 96 patients were eligible for further analysis. Results: The analysis points to a significant hearing improvement after ossiculoplasty with the preserved stapedial superstructure as compared with the patients after footplate mobilisation. On the other hand, the research results point to significantly smaller hearing improvement in those patients, in whom only stapes was preserved, as compared with those, in whom a more extensive reconstruction of the ossicular chain was possible. Conclusions: The air-bone gap measured before otosurgery often fails to reflect the extent of abnormalities and cannot, therefore, be considered as the only prognostic factor for postoperative hearing improvement. Stapes preservation is crucial for hearing improvement after middle ear 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>

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 Single Sitting Bilateral Myringoplasty: Outcomes and Complications

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M A Hassan ◽  
M S Hassaballah ◽  
P M Mikahail ◽  
M S D Mahmoud
Keyword(s):  
Hearing Loss ◽  
Success Rate ◽  
Tympanic Membrane ◽  
Otitis Media ◽  
Chronic Otitis Media ◽  
Psychological Trauma ◽  
Single Stage ◽  
Hearing Improvement ◽  
Suppurative Otitis Media ◽  
Graft Take

Abstract Background Tympanoplasty is the standard and well established procedure for closure of tympanic membrane perforations. Traditionally each ear drum is taken up for grafting sequentially in two different sittings. The reluctance to deal with both sides at the same sitting has been primarily due to a theoretical risk of iatrogenic sensory-neural hearing loss, need of bilateral ear canal gauze packing and chances of graft intake failure. Chronic Suppurative Otitis Media (CSOM) is a widely prevalent public health problem presenting with discomfort, hearing loss, otorrhea and psychological trauma. CSOM is characterized by an inflammatory process of the middle ear often associated with irreversible tissue alterations. It may be further classified into safe chronic otitis media and unsafe chronic otitis media according to the absence or presence of a cholesteatoma. Aim This study aim at assessing the single stage bilateral surgical procedure in bilateral tympanic membrane perforation caused by chronic otitis media as regard the graft take and hearing improvement as outcomes. Methodology A meta-analysis study is done to assess the feasibility and the possibility of operating the bilateral perforation in tympanic membrane in chronic otitis media cases on same session rather than doing it in separate sessions. The outcomes that were selected to evaluate such approach are graft take and hearing improvement. Hospital stay, cost of the operation and time were supposed to be evaluated however, there was no sufficient data to treat such outcomes in this meta analytic study upon that these outcomes are going to be appraised and stated bases on the available data. Results The graft take was evaluated on the bases paper by ototscopic examination post operative from 3 weeks to 3 months by closure of the perforation. It was estimated in this study to be 88%. This percent is matching the result obtained by Ihsan et al 2016 “who operated on 50 patients with a graft uptake rate of 86 %”, Olusesi et al, 2017 " with a total of 38 participants underwent either bilateral sequential same-day tympanoplasty (18 patients, 36 ears) or bilateral sequential different-day tympanoplasty (20 patients, 40 ears). The overall graft take rate was 88 per cent (32 out of 36 ears in the same-day tympanoplasty group, 35 out of 40 ears in the different-day tympanoplasty group; p = 0.96, odds ratio = 0.984)" (88 %), and Katsura et al, 2005 who revised the SUM using a 17 patients who underwent bilateral same-day surgery with a success rate of (85%). Conclusion Simultaneous bilateral myringoplasty is safe and effective as a single-stage operation with a high success rate as regard the graft take and hearing improvement.

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>

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