scholarly journals Paper patching in traumatic perforation of tympanic membrane

Author(s):  
Vinod Shinde ◽  
Sudeep Choudhary ◽  
Mayur Ingale ◽  
Paresh Chavan

<p class="abstract"><strong>Background:</strong> Traumatic perforations are not new for ENT surgeons. The dictum for treatment is to keep the ear dry and leave the tympanic membrane to heal by itself. Most of the time it heals completely, but if it does not, a tympanoplasty is required.</p><p class="abstract"><strong>Methods:</strong> 144 patients of traumatic tympanic membrane perforation, who reported in the outdoor patient department of Otorhinolaryngology, at Dr. D. Y. Patil Medical college, DPU, Pune, were divided in two random groups; Group A was treated with standard treatment while Group B was treated with patching of perforation as an adjuvant to standard treatment. A simple paper, (from the envelop of gel foam) was used for this procedure. The standard taught and performed treatment for a tympanic membrane perforation is administering antibiotics, antihistaminic and anti-inflammatory drugs and keeping the ear dry; leaving the perforation for spontaneous healing.  </p><p class="abstract"><strong>Results:</strong> Group A 75% perforations had healed while in Group B 97.22% perforations healed completely.</p><p class="abstract"><strong>Conclusions:</strong> Paper patching supports the healing tympanic membrane and significantly improves the chances of spontaneous healing thus reducing the requirement of surgical intervention.</p>

Author(s):  
Raies Ahmad ◽  
Gopika Kalsotra ◽  
Kamal Kishore ◽  
Aditiya Saraf ◽  
Parmod Kalsotra

<p class="abstract"><strong>Background:</strong> The aim of the study was to assess impact of duration of tympanic membrane perforation on hearing loss and postoperative audiological outcome using pure tone audiogram.</p><p class="abstract"><strong>Methods:</strong> The present study was conducted on 100 patients in department of ENT and HNS, SMGS Hospital, Government Medical College Jammu during a time period of November 2018 to October 2019. All the patients with age 15 to 60 years who presented with tympanic membrane (pars tensa) perforation were included in the study.  </p><p class="abstract"><strong>Results:</strong> In our study, mean preoperative hearing loss (AC threshold) of group A was 36.23±1.07 dB and of group B was 25.67±6.38 dB. Group C had mean preoperative hearing loss (AC threshold) of 28.78±6.50 dB. Mean preoperative air-bone gap (AB gap) of group A was 12.9±8.05dB and of group B was 13.86±4.19 dB. Group C had mean preoperative air-bone gap (AB gap) of 16.47±5.51 dB. Postoperatively, pure tone threshold at three months was least in group B (15.09±5.80 dB), followed by group C (15.68±4.66 dB) and group A (19.33±2.81 dB). Whereas, postoperative AB gap at 3 months was least in group C (10±3 dB), followed by group C (8.44±3.59 dB). Group B had maximum postoperative AB gap of 8.49±4.34 dB.</p><p class="abstract"><strong>Conclusions:</strong> This study did not show any correlation between duration of disease and degree of hearing loss.</p>


Author(s):  
Puneeth S. Nayak ◽  
Anil S. Harugop ◽  
Prashant H. Patil ◽  
Prasad T. V. R. K. ◽  
Lakshmi Goswami

<p class="abstract"><strong>Background:</strong> Chronic otitis media is a widespread disease of developing countries, especially of the lower socio-economic group. Medical cost in hospitals associated with tympanoplasty for treating CSOM is very high. Our study investigates the efficacy of epidermal growth factor along with chemical cautery in healing of chronic tympanic membrane perforation on an outpatient department (OPD) basis. Hence providing a cheaper and cost effective treatment alternative to the patients.</p><p class="abstract"><strong>Methods:</strong> A total number of 70 patients with signs of COM attending ENT OPD were selected. The patients were randomly assigned into 2 groups each with a sample size of 35. Otoendoscopy and pure tone audiometry was performed. Group A was treated with EGF with chemical cautery and group B was treated with only chemical cautery. Both groups were followed up after 15 days, one month and second month of the procedure in ENT outpatient clinic.</p><p class="abstract"><strong>Results:</strong> The success rate of these non-healing perforation was found to be significantly higher in group A (29 [82.86%]) compared with group B (17 [65.71%]) with P value of 0.0070*.</p><p class="abstract"><strong>Conclusions: </strong>This study shows a statistically significant result with topical application of epidermal growth factor in small to medium non-healing central tympanic membrane perforation. Due to the promising result of epidermal growth factor, it could be considered as office myringoplasty.  </p>


2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Taha M. Abdelaal ◽  
Ahmed A. Ibrahim

Abstract Background Temporalis fascia and perichondrium are still the most successful graft materials for primary microscopic repair of tympanic membrane perforations worldwide with 80% to 90% success rate. However, minimally invasive surgery is becoming standard in many fields and the endoscope has been largely incorporated in ear surgery over the past 10 years. This study aimed to evaluate the success rate of endoscopic transcanal closure of tympanic membrane perforation using Tutoplast® compared with the conventional post auricular approach using homologous temporalis fascia graft. Results Our study was conducted on 50 patients, were equally divided into 2 groups. Group A patients have been operated endoscopic transcanal using the Tutoplast as a graft material. Group B patients have been operated using a temporalis fascia graft through a post-auricular approach. The graft take rate, the pre- and post-operative pure tone audiogram, and operative time were compared in both the groups. The graft uptake rate was 100% in both groups. The mean of ABG showed significant improvement in both groups. In group A, the mean of ABG was 28.2 pre-operatively and became 12.12 post-operatively. In group B, the mean of ABG was 29.72 pre-operatively then became 15.2 post-operatively. Comparing the mean of post-operative ABG between both groups showed statistically significant difference as p value was 0.000496. We found a significant difference of the mean average operative time between both groups as the mean average time for group A was 48.08 min compared to 69.4 min for group B with p value 0.049772295. Conclusions Endoscopic closure of tympanic membrane perforation using Tutoplast is successful short-time procedure avoiding the postauricular or endaural incisions with shorter operative time.


2019 ◽  
Vol 24 (2) ◽  
pp. 131-136
Author(s):  
Md Abdur Razzak ◽  
KM Mamun Murshed ◽  
AKMA Sobhan ◽  
Md Rakib Hossain ◽  
SM Nafeez Imtiaz

Background: Myringoplasty is one of the surgical techniques for the management of chronic supportive otitis media with permanent perforation of tympanic membrane. It is defined as simple surgical repair of tympanic membrane perforation without doing ossicular reconstruction. Objective: To determine the success rate of myringoplasty and to examine whether the hearing improvement is a potential indication for surgery. Methods: This study was conducted in the Department of Otorhinolaryngology and Head and Neck Surgery, Shaheed Suhrawardy Medical College Hospital from January 2017 to December 2017 and 100 patients who underwent myringoplasty in this period were analyzed. About 100 patients with dry central tympanic membrane perforations of various size were included in this study Results: Myringoplasty was performed in 100 patients. Male were (45%) and females were (55%).Twenty one (7%) of them belonged to age group of 10-20 years, 31 (31%) were in the age range of 21-33 years, 38(38%) were the age range 31-40 years while 24 (24%) aged between 41-50 years with mean age of 26.32 ±S.D 9.59 years. Overall success rate of graft uptake was noted in 88 (88%) out of 100 cases Conclusion: Myringoplasty is a safe surgical procedure in achieving intact tympanic membrane and to improve the hearing loss. Therefore, underlay technique being technically simple should be preferred, but the ultimate decision about the technique to be employed depends on the surgeons preference and the site of perforation  Bangladesh J of Otorhinolaryngology; October 2018; 24(2): 131-136


2020 ◽  
Vol 134 (9) ◽  
pp. 779-783
Author(s):  
D Wang ◽  
W Wang

AbstractObjectiveThe aim of this study was to compare the differences between the no tympanomeatal flap approach and the tympanomeatal flap approach in endoscopic myringoplasty.MethodA total of 132 patients with tympanic membrane perforation were randomly divided into two groups: the no tympanomeatal flap approach group (group A, 56 ears) and the tympanomeatal flap approach group (group B, 76 ears). A comparison between the two groups was made.ResultsThe average operation time of group A was 36.00 ± 5.24 minutes, which was significantly shorter than that of group B, which was 43.89 ± 4.57 minutes (p = 0.002). The blood loss of group A was 5.08 ± 1.83 ml, which was significantly less than that of group B (9.67 ± 2.29 ml; p < 0.001). There were no differences in the degree of hearing improvement, the rate of hearing improvement, the dry ear time (when the external auditory canal and the operating cavity were dry) after operation and the success rate of tympanic membrane repair when compared between the two groups.ConclusionCompared with group B, group A (no tympanomeatal flap approach) can achieve the same effect but has the advantages of a shorter operation time and less blood loss during the operation.


2021 ◽  
Vol 71 (Suppl-3) ◽  
pp. S552-55
Author(s):  
Saleem Asif Niazi ◽  
Shahzad Maqbool ◽  
Yousra Riaz ◽  
Zafarullah Khan ◽  
Shafaq Zaman ◽  
...  

Objective: To determine the efficacy of permeatal ednoscopic myringoplasty, in inactive (mucosal) COM regarding, graft take and hearing improvement. Study Design: Quasi-experimental study. Place and Duration of Study: ENT Department, Pak Emirates Military Hospital, Rawalpindi, from Aug 2019 to Feb 2020. Methodology: This was conducted on a sample size of n=100. Patients having inactive (mucosal) COM with dry central small, medium and large perforations were included. Patients were divided in to three groups on the basis of age, group A 15-30 years, group B 31-45 years and group C 46-60 years. All the patients underwent per-meatal endoscopic myringoplasty, without raising the tympano-meatal flap, under general anesthesia. Patients were followed up over a period of six months. Graft take was assessed by microscopy. Hearing was assessed by Pure Tone Audiometry (PTA) with improvement in air bone gap to 15db as primary end point. Data was collected on structured performa. Data was analyzed using SPSS version 17. Results: In this study, 33 (33%) were males and 67 (67%) were females. Age ranged 15-60 years. Out of 5 patients lost to follow up. A total of 95 completed their follow up. Based on age of the patients, in group A, successful graft take was 100%. In group B, it was 91% & in group C it dropped to 46%. On the basis of tympanic membrane perforation size, the graft success rate in small perforations was 94.8%; in medium sized perforations it was 86.8% and in large sized perforations of tympanic membrane it was........


Author(s):  
Jitendra Rathod ◽  
Reena Vare ◽  
Annju Thomas

<p><strong>Background:</strong> The objective of the study was to evaluate the role of endoscopes in the management of dry central perforations of the tympanic membrane, compare the visualization of middle ear anatomy, time taken for the procedure and each step of the surgery and preoperative and postoperative hearing results/improvement.</p><p><strong>Methods: </strong>Fifty patients of chronic suppurative otitis media without cholesteatoma who came to ENT OPD at MGM medical college and hospital Aurangabad were included. They were divided into 2 groups with 25 patients each. Group A underwent microscopic approach to tympanoplasty and group b underwent endoscopic approach to tympanoplasty. Patients were assessed pre and postoperatively after 7 days, 14 days, 1 month, 3 months and 6 months with postoperative audiometry in the third month. <strong></strong></p><p><strong>Results: </strong>There was an improvement in the post-operative audiometry air bone gap (ABG) in both the groups. The operative time for group A was comparatively lesser than group B. Residual perforation were detected in one patient in group A at postoperative months 3 and 6, and for group B at postoperative month 3 and in two patients at postoperative month 6.<strong></strong></p><p><strong>Conclusions: </strong>A shorter operative duration is an advantage of microscopic tympanoplasty technique. One handed technique is one of the disadvantages of endoscope. The endoscopic approach gave better results in terms of easy visualization of the entire tympanic membrane and ossicular system. Tympanoplasty using endoscope was found to be an effective method for management of dry central perforations of the tympanic membrane.<strong></strong></p>


2017 ◽  
Vol 5 (1) ◽  
pp. 14-16
Author(s):  
Shiwani Rai ◽  
K. Koirala ◽  
V. Sharma

Objective: To study the role of nasal decongestants in spontaneous healing of traumatic tympanic membrane perforation.Material and Methods: A prospective single blinded, randomized controlled study was carried out in the department of ENT, Manipal College of Medical Sciences, Pokhara, Nepal. Patients with traumatic tympanic membrane perforation were divided into two groups; those receiving nasal decongestants along with conservative measures (Group1) and those receiving conservative measures only (Group2). Healing of tympanic membrane was compared in between these groups at 1 and 3 months. Statistical analysis was done using SPSS 20.Results: There were 30 patients in group 1 and 28 patients in group 2. The mean age of the study population was 26.98 (SD= 7.53). The M: F ratio in group 1 was 0.58:1 and that in group 2 was 0.56:1. Complete healing was seen in 25 (83%) patients in group 1 and 16 (57.1%) patients in group 2 at the end of 1 month (P=0.029). Similarly, healing was seen in in 29 (96.7%) patients in group 1 and 21 (75%) patients in group 2 at the end of 3 months (P=0.023).Conclusion: Routine use of nasal decongestants increases the chances of spontaneous healing of traumatic tympanic membrane perforations.  


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