scholarly journals Comparative study of anterior tucking and cartilage support tympanoplasty with respect to graft uptake and hearing outcome

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>

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):  
G. Abhinav Kiran ◽  
Y. Prabhakara Rao ◽  
B. Shanthi Priyanka ◽  
Supreety .

<p class="abstract"><strong>Background:</strong> Chronic suppurative otitis media is a widespread disease for which tympanoplasty is frequently undertaken. Gel-foam may cause adhesions and fibrosis and improper packing may physically alter the structure of the tympanic membrane leading to failure of tympanoplasty. The graft can be placed without any middle ear supporting agent wherein the graft is held in position by the surface tension between the novel graft placed and the remnant tympanic membrane. The objectives of this study were to assess the graft uptake and hearing improvement following type 1 tympanoplasty with gel-foam in the middle ear and without gel-foam in the middle ear and to compare and assess results.</p><p class="abstract"><strong>Methods:</strong> This was a randomized control trial done for a period of one year conducted in the department of ENT, at a tertiary referral hospital. 40 patients with dry perforation underwent type 1 tympanoplasty without gel-foam in the middle ear and 40 patients with dry perforation underwent type 1 tympanoplasty with gel-foam in the middle ear. Post-operative follow-up was done to look for graft uptake. Hearing assessment by pure tone audiometry was done 90 days post-operatively.  </p><p class="abstract"><strong>Results:</strong> Graft uptake was 82.5% in type 1 tympanoplasty without gel-foam in the middle ear and 85% with gel-foam in the middle ear. Both types of surgeries had significant hearing improvement.</p><p class="abstract"><strong>Conclusions:</strong> Graft uptake is equally good in cases with gel-foam and without gel-foam. Hearing gain is comparable in both groups of patients.</p>


Author(s):  
Nabeel Malick ◽  
Raveendra P. Gadag ◽  
Vidyashree K. M. ◽  
Shruthi Puthukulangara

<p class="abstract"><strong>Background:</strong> Chronic suppurative otitis media is a widespread disease with a significant cause of morbidity with a greater burden in the poor communities of the developing countries for which tympanoplasty is frequently undertaken. Gelfoam may show detrimental effects such as adhesions and fibrosis and improper packing may physically alter the structure of the tympanic membrane leading to failure of tympanoplasty. The graft can be placed without any middle ear supporting agent wherein the graft is held in position by the surface tension between the novel graft placed and the remnant tympanic membrane. This provides the added advantage of facilitating middle ear ventilation through the Eustachian tube. The objectives of the study were to assess the graft uptake and hearing improvement following type 1 tympanoplasty with gelfoam in the middle ear and without gelfoam in the middle ear and to compare and assess results for complications</p><p class="abstract"><strong>Methods:</strong> This was a randomised control trial done for a period of one year conducted in the department of otorhinolaryngology and head and neck surgery, Karnataka Institute of Medical Sciences, Hubballi which is a tertiary referral hospital. 30 patients underwent type 1 tympanoplasty without gelfoam in the middle ear and 31 patients underwent type 1 tympanoplasty with gelfoam in the middle ear. Post-operative follow up was done to look for graft uptake, hearing assessment by pure tone audiometry and impedance audiometry was done 90 days post-operatively.  </p><p class="abstract"><strong>Results:</strong> Graft uptake was 80% in type 1 tympanoplasty without gelfoam in the middle ear and 80.6% with gelfoam in the middle ear. Both types of surgeries had significant hearing improvement, and complications like retraction and residual perforation were also comparable. Ad type of impedance curve is most common post operatively.</p><p><strong>Conclusions:</strong> Graft uptake is equally good in cases with gelfoam and without gelfoam. Hearing gain is comparable in both groups of patients. No significant complications occurred in our study. ‘Ad’ is the most common type of impedance curve after surgery. Long term follow up is important in these patients. </p>


ORL ◽  
2009 ◽  
Vol 71 (1) ◽  
pp. 71-73 ◽  
Author(s):  
Akinobu Kakigi ◽  
Taizo Takeda ◽  
Hiroaki Nakatani ◽  
Kenichi Kozakura ◽  
Shoichi Sawada ◽  
...  

1999 ◽  
Vol 109 (5) ◽  
pp. 712-716 ◽  
Author(s):  
Vikram J. Jaisinghani ◽  
Michael M. Paparella ◽  
Patricia A. Schachern ◽  
Chap T. Le

2015 ◽  
Vol 7 (2) ◽  
pp. 55-60 ◽  
Author(s):  
Sanjeev Kumar Thakur ◽  
Sanjay Kumar Singh ◽  
Anwar Afaque ◽  
Nisha Ghimire

Background: The history of tympanoplasty is well over a century. Type 1 tympanoplasty is an established procedure worldwide with a variation in the outcome.Aims and Objectives: To analyze the outcome of Type 1 tympanoplasty surgeries in terms of graft success and hearing improvement done at the Ear Department of Biratnagar eye hospital in eastern Nepal and discuss the various factors that might have influenced it.Materials and Methods: Retrospective analysis of records of the cases that underwent Type 1 tympanoplasty from August 2013 to January 2015 was done. The factors analysed were age, gender, the side of the affected ear and the perforation size. Appropriate Statistical test was applied and the results were discussed.Results: A total of 151 cases of type 1 Tympanoplasty were analysed were females had higher frequency than males, with higher incidence at younger age. The mean age of successful cases was 28.53. Females had a better success rate in terms of graft success compared to males. Moderate size perforations had the best outcome of graft success and least were of small size perforations. Of all cases analyzed, hearing improvement was observed in maximum cases.Conclusion: There was no significant influence of age or gender on the hearing outcome. The difference of hearing improvement according to size of perforation was also not significant.Asian Journal of Medical Sciences Vol.7(2) 2015 55-60


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>


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