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

Background: 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.Methods: 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. Results: 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%.Conclusions: 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.

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TO ASSESS THE OUTCOME OF ENDOSCOPIC INTERLAY TYMPANOPLASTY IN TERTIARY CARE CENTER

10.36106/ijsr/5114125 ◽

2021 ◽

pp. 73-75

Author(s):

Pasunuti Shravya ◽

Jyothi Swarup ◽

Vigeshwar RK

Keyword(s):

Success Rate ◽

Otitis Media ◽

Care Center ◽

Tertiary Care ◽

Chronic Otitis Media ◽

Hearing Improvement ◽

Suppurative Otitis Media ◽

Conducting Mechanism ◽

Conductive Hearing ◽

Middle Ear Cleft

Background: Chronic otitis media is an inammatory process in middle ear cleft which is treated by a common otological procedure tympanoplasty to reconstruct the tympanic membrane and to restore sound-conducting mechanism. Rigid endoscope in transcanal interlay tympanoplasty has signicant advantage as it provides magnied, and wide angle view, with better success rate and postoperative hearing gain. The Aims and objectives were to assess the outcome of endoscopic interlay tympanoplasty, in terms of graft uptake, hearing improvement and rate of complications in cases of inactive mucosal chronic suppurative otitis media. Methods: This prospective study was conducted for 1 year at our institution in 50 patients having conductive hearing loss with dry, central perforation. All patients underwent transcanal endoscopic interlay tympanoplasty and were followed up for 3months to determine the graft uptake, hearing improvement and rate of complications. Results: Graft uptake rate in the present study was found to be 98% with residual perforation as a complication in 2% patients and no other complications were encountered. Post operatively air bone gap (ABG) after 12 weeks found to be < 20 dB ABG in 84% patients. Conclusion: Endoscopic interlay tympanoplasty is a effective method with high success rate both in terms of graft uptake as well as post operative hearing improvement and can be implemented in all cases of inactive mucosal COM.

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A clinical study of evaluation of tympanoplasty with mastoidectomy in mucosal chronic otitis media

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20195709 ◽

2019 ◽

Vol 6 (1) ◽

pp. 163

Author(s):

Ritesh Mahajan ◽

Nidhi Abraham ◽

Nagaraj T. M.

Keyword(s):

Otitis Media ◽

Disease Process ◽

Chronic Otitis Media ◽

Chronic Suppurative Otitis Media ◽

Suppurative Otitis Media ◽

Medical College ◽

Cortical Mastoidectomy ◽

A Prospective Study

Background: Chronic suppurative otitis media (CSOM) is one of the most common ear diseases in developing countries with a varying incidence of 3% to 57%. It the disease process is further divided into mucosal type and squamosal type depending on clinical presentation. The mainstay of therapy in CSOM remains surgery which aims at eradication of disease and restoring the hearing mechanism. The main objective of our study was to evaluate the changes and impact of tympanoplasty with mastoidectomy as a surgical treatment modality in mucosal type of CSOM.Methods: A prospective study was conducted in Rajarajeshwari Medical College and Hospital between November 2015 and June 2017, involving 50 patients with mucosal type of chronic otitis media. These patients, after complete clinical examination and hearing analysis, underwent tympanoplasty with cortical mastoidectomy. Follow-up of the patients was done at one month and three months after the surgery where the parameters recorded preoperatively were assessed. Results: The graft uptake three months after the surgery was 94%. Patients reported a subjective improvement in symptoms of ear discharge, decreased hearing, earache and tinnitus to 94%, 70%, 86% and 78% respectively. There was hearing improvement in ears that had discharge preoperatively and those ears that did not.Conclusions: Chronic suppurative otitis media is a very common problem and it can lead to recurrent ear discharge and hearing problems. Timely intervention is necessary as early diagnosis results in good surgical outcomes and can make an impact on patient’s quality of life.

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Effectiveness of transperforation myringoplasty in bilateral chronic otitis media patients undergoing contralateral tympanoplasty

The Journal of Laryngology & Otology ◽

10.1017/s0022215116009646 ◽

2016 ◽

Vol 131 (1) ◽

pp. 64-68 ◽

Cited By ~ 3

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.

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Myringoplasty with and without Cortical Mastoidectomy in Treatment of Non-cholesteatomatous Chronic Otitis Media: A Comparative Study

Clinical Medicine Insights Ear Nose and Throat ◽

10.4137/cment.s17980 ◽

2014 ◽

Vol 7 ◽

pp. CMENT.S17980 ◽

Cited By ~ 5

Author(s):

Hazem Mohammed Abdel Tawab ◽

Fadi Mahmoud Gharib ◽

Tareq M. Algarf ◽

Louay S. EISharkawy

Keyword(s):

Otitis Media ◽

Chronic Otitis Media ◽

Suppurative Otitis Media ◽

Tympanic Membrane Perforations ◽

Cortical Mastoidectomy ◽

Significant Difference ◽

Graft Success ◽

A Prospective Study ◽

Department Faculty

Objective To compare the outcome and success of repair of uncomplicated tympanic membrane perforations with myringoplasty alone and when combined with mastoidectomy. Methods A prospective study where 40 patients with non-cholesteatomatous chronic suppurative otitis media (CSOM) were recruited during the period of June 2013 to December 2013 from the outpatient clinic of Otorhinolaryngology department, Faculty of medicine, Cairo University. Patients were managed medically and after dryness of their perforations they were operated upon. Twenty patients underwent simple myringoplasty alone and 20 patients underwent myringoplasty with cortical mastoidectomy. Underlay technique with temporalis fascia was done for all patients. Follow-up period was at least 3 months. Results Hearing improvement was comparable in both groups. There was no significant difference in graft uptake between the myringoplasty alone group (70%) and cortical mastoidectomy group (80%) ( P = 0.7). There was no significant difference in ear dryness between the myringoplasty alone group (75%) and cortical mastoidectomy group (90%) ( P = 0.4). Conclusion Mastoidectomy performed in non-cholesteatomatous CSOM in this study gives no statistically significant benefit over simple myringoplasty as regards graft success rate and dryness of the middle ear with comparable hearing outcome.

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Comparison of Endoscopic Cartilage Myringoplasty in Dry and Wet Ears With Chronic Suppurative Otitis Media

Ear Nose & Throat Journal ◽

10.1177/0145561321999263 ◽

2021 ◽

pp. 014556132199926

Author(s):

Juanmei Yang ◽

Jihan Lyu ◽

Yanmei Wang ◽

Binjun Chen ◽

Jianghong Xu ◽

...

Keyword(s):

Success Rate ◽

Otitis Media ◽

Tertiary Hospital ◽

Chronic Suppurative Otitis Media ◽

Hearing Improvement ◽

Suppurative Otitis Media ◽

Hearing Gain ◽

Significant Difference ◽

Endoscopic Myringoplasty ◽

Graft Success

Objectives: This study compared the rate of graft success, as well as hearing improvement and dry ear time between dry ears and wet ears with otomycosis or without otomycosis in patients with chronic suppurative otitis media (CSOM) after endoscopic cartilage myringoplasty. Methods: This retrospective study was conducted in a tertiary hospital in Shanghai. In total, 83 patients with CSOM (43 with dry ears and 40 with wet ears) were included. Among the 40 patients with CSOM and wet ears, 25 exhibited otomycosis. All patients underwent endoscopic myringoplasty, and perforations were repaired using tragal cartilage with a single-sided perichondrium. Patients were followed up for at least 6 months. Pure-tone hearing was examined preoperatively and at 3 months postoperatively. The graft uptake rate, hearing improvement, and dry ear time were compared between the groups. Results: The graft success rate did not differ significantly between the dry-ear and wet-ear groups (95.35% and 90.00%, respectively). Furthermore, the graft success rate also did not differ significantly between patients with wet ears and otomycosis and those with wet ears without otomycosis (92.00% and 86.67%, respectively). Hearing gain did not differ significantly between the dry-ear and wet-ear groups. No significant difference in hearing gain was also found in patients with wet ears with or without otomycosis. However, the time to dry ear was significantly longer in the wet-ear group than in the dry-ear group. Conclusion: Patients with CSOM and wet ears required more time to achieve a completely healthy status. However, the graft success rate and hearing improvement were not affected by a wet middle ear and otomycosis. Thus, endoscopic myringoplasty using tragus cartilage is an effective treatment for refractory CSOM in patients with wet ears and otomycosis.

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

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20173051 ◽

2017 ◽

Vol 3 (3) ◽

pp. 705 ◽

Cited By ~ 1

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

Background: 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.Methods: 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. Results: 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>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>0.05).Conclusions: 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.

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Stapedectomy following tympanoplasty

The Journal of Laryngology & Otology ◽

10.1258/0022215011908072 ◽

2001 ◽

Vol 115 (6) ◽

pp. 444-446 ◽

Cited By ~ 4

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.

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A Prospective Comparative Study between Dry and Wet Tympanoplasty

Annals of Otology and Neurotology ◽

10.1055/s-0038-1676951 ◽

2018 ◽

Vol 01 (02) ◽

pp. 083-088 ◽

Cited By ~ 1

Author(s):

Hepsiba Pothala ◽

Sunita Shukla ◽

Wasim Khan ◽

Ravi Ramalingam ◽

Kombupalayam Ramalingam

Keyword(s):

Comparative Study ◽

Otitis Media ◽

Uptake Rate ◽

Chronic Otitis Media ◽

Hearing Improvement ◽

Temporalis Fascia ◽

Suppurative Otitis Media ◽

Significant Difference ◽

Prospective Comparative Study ◽

Contralateral Ear

Abstract Background Tympanoplasty is the well-established procedure for closure of perforations of tympanic membrane. Study Design This study was a prospective comparative study. Objective The objective of this study was to compare the hearing improvement and graft uptake rate between dry and wet tympanoplasty performed on tubotympanic type of chronic suppurative otitis media. Materials and Methods One hundred forty patients with tubotympanic type of chronic otitis media were selected and categorized into dry and wet ears. Tympanoplasty was performed using temporalis fascia by underlay technique in all cases. Postoperatively, graft uptake rate and hearing improvement were analyzed. Results The graft uptake rate was equal in both dry and wet ears, which was statistically insignificant. There was no statistically significant difference in the hearing improvement between the dry ears and wet ears (χ – 2.39, p = 0.122). Conclusion Factors such as age, sex, and status of the contralateral ear and wet ear did not have any impact on the postoperative graft uptake of tympanoplasty. There was no difference in the graft uptake between the dry and wet ears and there was no statistically significant difference between hearing improvement in both and wet ears.

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Comparative study of efficacy of graft placement with and without anterior tagging in type one tympanoplasty for mucosal-type chronic otitis media

The Journal of Laryngology & Otology ◽

10.1017/s0022215111002659 ◽

2011 ◽

Vol 126 (2) ◽

pp. 125-130 ◽

Cited By ~ 14

Author(s):

P Hosamani ◽

L Ananth ◽

S B Medikeri

Keyword(s):

Otitis Media ◽

Chronic Otitis Media ◽

Type I ◽

Graft Material ◽

Hearing Improvement ◽

Hearing Results ◽

Graft Placement ◽

Type I Tympanoplasty ◽

Suitable Technique

AbstractObjectives:To assess the efficacy of anterior tagging of graft material with respect to graft uptake and hearing results, in type I tympanoplasty.Study design:Prospective, randomised, cohort study.Methods:Sixty patients with chronic otitis media of the mucosal type, with pars tensa perforations, were included in the study. Patients were randomly allocated to two groups: group one underwent type one tympanoplasty with anterior tagging, while group two underwent type one tympanoplasty without anterior tagging. Follow up included evaluation of graft uptake and hearing improvement.Results:There were 33 patients in group one and 27 patients in group two. The overall incidence of successful graft uptake was 96.96 per cent in group one and 81.5 per cent in group two. Closure of central and posterior perforations was successful in 100 per cent of both groups. Closure of anterior and subtotal perforations was successful in 95.45 per cent of group one and 54.54 per cent of group two.Conclusion:Type one tympanoplasty with anterior tagging of graft material is a suitable technique for anterior and subtotal perforations.

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

The Journal of Laryngology & Otology ◽

10.1017/s0022215108003708 ◽

2008 ◽

Vol 123 (4) ◽

pp. 383-390 ◽

Cited By ~ 11

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.

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