scholarly journals Hearing gain after tympanoplasty: a prospective study

2020 ◽  
Vol 6 (6) ◽  
pp. 1096
Author(s):  
Manzoor Ahmad Latoo ◽  
Romesh Bhat ◽  
Aleena Shafi Jallu
Keyword(s):  
Hearing Loss ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Type I ◽  
Type Ii ◽  
Canal Wall ◽  
Type Iv ◽  
Canal Wall Down ◽  
Type I Tympanoplasty ◽  
Canal Wall Up

<p class="abstract"><strong>Background:</strong> The aim of the present study was to determine hearing improvement in different types of tympanoplasties by comparing mean preoperative air bone (AB) gap with mean postoperative AB gap. The study focused on reconstruction of tympanic membrane and ossicular apparatus by tympanoplasty alone or tympanoplasty with mastoid surgeries (canal wall up or canal wall down).</p><p class="abstract"><strong>Methods:</strong> 60 patients of either sex having chronic otitis media with conductive hearing loss of &gt;20 dB were included in the study. Each patient had to undergo preoperative and postoperative pure tone audiometry to calculate average AB gap. Patients underwent tympanoplasty, with or without mastoid exploration depending on the disease status. Pure tone audiometry (PTA) was done at 3 months and 6 months and compared with pre-operative PTA.  </p><p class="abstract"><strong>Results:</strong> Preoperatively PTA showed 29 (48.33%) patients had mild degree of hearing loss, followed by moderate degree of hearing loss in 18 (30.0%) patients. 10 (16.67%) patients had minimal hearing loss and moderately severe hearing loss was seen in 3 (5%) patients. Tympanoplasty alone was done in 52 patients (86.67%). Tympanoplasty with canal wall up mastoidectomy was done in 6 (10%) and tympanoplasty with canal wall down mastoidectomy was done in 2 (3.33%) patients. Type I tympanoplasty was performed in 37 (61.6%) patients, type-III tympanoplasty was the type of surgery in 15 (25.0%) patients. Type II and type IV tympanoplasties were performed in 4 (6.7%) patients each separately.</p><p class="abstract"><strong>Conclusions:</strong> Hearing gain is better in type I tympanoplasty than in tympanoplasty type II, type III and type IV with or without mastoid surgeries.</p><strong></strong>

scholarly journals A comparative study of hearing outcomes in canal wall up versus canal wall down mastoidectomy in our experience

2019 ◽  
Vol 5 (2) ◽  
pp. 472
Author(s):  
Poornima S. Bhat ◽  
G. Gandhi ◽  
K. Pradheep
Keyword(s):  
Hearing Loss ◽  
Conductive Hearing Loss ◽  
Pure Tone Audiometry ◽  
Canal Wall ◽  
Hearing Gain ◽  
Hearing Outcome ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy ◽  
Conductive Hearing ◽  
Canal Wall Up

<p class="abstract"><strong>Background:</strong> COM causes considerable morbidity with ear discharge, conductive hearing loss and complications. Ossicular reconstruction is a surgical procedure which intends to improve the quality of hearing and life in such patients. Comparison of the outcomes will help to determine the merits or demerits of a particular procedure.</p><p class="abstract"><strong>Methods:</strong> The study was conducted in the Department of ENT, VIMS, Bellary during the period from December 2010 to May 2012. All the patients with CSOM with ossicular erosion suggested by conductive hearing loss more than 40dB were included in the study. A detailed history taking, thorough clinical examination was done for these patients. Before and after the procedure pure tone audiometry was done to assess the hearing outcome. Post operatively PTA was done in 6<sup>th</sup> week, 3<sup>rd</sup> month, 6<sup>th</sup> month follow up. Hearing improvement was analysed according to the type of procedure. The data collected was tabulated and subjected to statistical analysis.  </p><p class="abstract"><strong>Results:</strong> This study compared the outcomes of hearing gain in canal wall up versus canal wall down mastoidectomy surgeries. Hearing gain was better in canal wall up mastoidectomy (18.36 dB) than canal wall down mastoidectomy surgeries.</p><p class="abstract"><strong>Conclusions:</strong> Hearing outcome was better in intact canal wall mastoidectomy than canal wall down mastoidectomy in our study.</p><p class="abstract"> </p>

scholarly journals Functional outcomes of middle ear cholesteatoma surgery

2018 ◽  
Vol 71 (3-4) ◽  
pp. 109-113
Author(s):  
Dalibor Vranjes ◽  
Sanja Spiric ◽  
Slobodan Spremo ◽  
Dmitar Travar ◽  
Predrag Spiric ◽  
...  
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Lower Incidence ◽  
Functional Outcomes ◽  
Pure Tone ◽  
Chronic Otitis Media ◽  
Pure Tone Audiometry ◽  
Canal Wall ◽  
Canal Wall Down ◽  
Canal Wall Up

Introduction. Chronic otitis media is defined as a persistent inflammation of the middle ear with signs of an infection lasting for three months or longer. Chronic otitis media may occur either with or without cholesteatoma. For both types of conditions, surgical treatment with closed canal wall-up or open canal wall-down techniques of tympanoplasty are considered. Our aim was to evaluate functional outcomes in two groups of patients (chronic otitis media with cholesteatoma and chronic otitis media without cholesteatoma) treated with various tympanoplasty techniques. Material and Methods. This retrospective study included 100 patients who underwent canal wall-down and canal wall-up tympanoplasty for the treatment of chronic otitis media with cholesteatoma and chronic otitis media without cholesteatoma from 2015 to 2016. All study patients underwent routine clinical and audiometric examinations. The study evaluated preoperative and postoperative functional results (evaluation of pure-tone audiogram screening). Results. A statistically significant lower incidence (p < 0.05) of postoperative air-bone gap < 20 decibels was established in patients with chronic otitis media with cholesteatoma, but there were no statistically significant differences between the two groups. There was a statistically lower incidence (p < 0.05) of patients with postoperative pure tone audiometry < 40 decibels in patients with chronic otitis media with cholesteatoma, but the difference between the two groups was not statistically significant. When analyzing the mean postoperative pure tone audiometry and air-bone gap in the study patients, canal wall-up tympanoplasty was found to be statistically more effective (p < 0.05). Conclusion. Various pathomorphological and pathophysiological changes in the middle ear, presence of extensively different forms of cholesteatomas, the choice of surgical procedures and poor preoperative hearing are in direct correlation with postoperative hearing.

scholarly journals Mastoidectomy: retrospective analysis of 137 cases in a tertiary care hospital

2017 ◽  
Vol 4 (1) ◽  
pp. 93
Author(s):  
Jaya Chrisanthus ◽  
Shibu George
Keyword(s):  
Tertiary Care ◽  
Chronic Otitis Media ◽  
Positive Association ◽  
Type I ◽  
Care Hospital ◽  
Facial Canal ◽  
Canal Wall ◽  
College Hospital ◽  
Canal Wall Down ◽  
Canal Wall Up

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Mastoidectomy is a common otologic surgery and at times can be a lifesaving procedure. The aim of the study is to analyze surgical indications, operative parameters and per-operative findings encountered. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">This is a retrospective study done in patients who had undergone mastoid surgeries between 1<sup>st</sup> Jan 2016 to 31<sup>st</sup> Dec 2016 in the Department of Otorhinolaryngology, Govt. Medical College hospital, Trivandrum.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Of the 137 patients the peak age incidence was 16 – 30 years. Cholesteatoma was present in 32% of which 91% had canal wall down mastoidectomy. 64% patients, mostly chronic otitis media- mucosal and inactive squamosal, underwent canal wall up procedure. In 62% cases the ossicular chain was eroded, which was mainly incus (87%). Abnormalities encountered within the mastoid during surgery were mainly dehiscent facial canal (17.5%), low lying dura (16.8%) and contracted antrum (15.3%). A positive association could be noted between contracted antrum and the position of sinus and dural plates, and was statistically significant. Co-existence of facial canal dehiscence with lateral canal fistula and dural plate dehiscence were also noted. The tympanoplasty procedures commonly employed in canal wall up procedures was Type I and 2, and in canal wall down procedure was Type 3. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Adequate skill development of the ear surgeons in the tertiary centre should be ensured, to individualize the procedure appropriate for each patient and optimize the outcome of surgery. Early referral to the nearby otological centre should be promoted not only to prevent complications but also for better post-surgical functional outcome.</span></p>

DYNAMIC STUDY OF HEARING IN CHILDREN AFTRE SANTIZING SERGON ON THE MIDDEL EAR

2019 ◽  
Vol 25 (3) ◽  
pp. 21-27
Author(s):  
E.A. Сhernogaeva ◽  
◽  
P.V. Pavlov ◽  
О.К. Gorkina ◽  
M.L. Zakharova ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Dynamic Assessment ◽  
Canal Wall ◽  
Suppurative Otitis Media ◽  
Saint Petersburg ◽  
Hearing Ability ◽  
Canal Wall Down ◽  
Bilateral Lesions ◽  
Medical University ◽  
Canal Wall Up

Dynamic assessment of hearing in pediatric patients having chronic suppurative otitis media with cholesteotoma was conducted. The patients included into the study were assessed after surgeries performed by canal wall up or canal wall down technique without any timpanoplasty. Functional outcomes and frequency of recurrence were estimated. We carried out a retrospective and prospective analysis of hearing ability in 35 children who had undergone surgery in ENT clinic of Saint-Petersburg State Pediatric Medical University (37 ears were operated on as two patients had bilateral lesions). Hearing ability was investigated by tone threshold audiometry. All the patients studied were followed up for not less then 1 year. Hearing ability was evaluated before the surgery,6 months and 12 months after the surgery. Hearing findings before the surgery in children operated on by canal wall up technique showed a more significant hearing loss than the ones done by the other technique. All ears demonstrated no significant hearing loss progress in both groups. However, the children after canal wall up surgery showed more frequent cholesteatoma recurrences which resulted in the need of other surgeries. Carrying out canal wall up surgery on the middle ear in children makes it possible to maintain hearing at a socially adequate level.

Clinical features and radiological evaluation of otic capsule sparing temporal bone fractures

2017 ◽  
Vol 131 (3) ◽  
pp. 209-214 ◽  
Author(s):  
S W Song ◽  
B C Jun ◽  
H Kim
Keyword(s):  
Hearing Loss ◽  
Temporal Bone ◽  
Facial Paralysis ◽  
Bone Fractures ◽  
Regional Analysis ◽  
Pure Tone Audiometry ◽  
Type I ◽  
Otic Capsule ◽  
Type Iv ◽  
Temporal Bones

AbstractObjective:To evaluate the clinical and radiological aspects of otic capsule sparing temporal bone fractures.Methods:Using medical records, 188 temporal bones of 173 patients with otic capsule sparing temporal bone fractures were evaluated. Otoscopic findings and symptoms, facial paralysis, and hearing loss were assessed.Results:Using regional analysis, 7 fractures were classified as type I, 85 as type II, 169 as type III and 114 as type IV. Fourteen of the 17 facial paralysis cases improved to House–Brackmann grade II or lower at an average of 57.6 days after the initial evaluation. Thirty-one patients underwent initial and follow-up pure tone audiometry examinations. The air–bone gap closed significantly from 27.2 dB at an average of 21.8 days post-trauma to 19.6 dB at an average of 79.9 days post-trauma, without the need for surgical intervention.Conclusion:Initial conservative treatment for facial paralysis or conductive hearing loss is possible in otic capsule sparing fracture cases after careful evaluation of the patient.

scholarly journals Study of Hearing Status After Canal Wall Down Mastoidectomy with Type-III Tympanoplasty

2020 ◽  
Vol 23 (1) ◽  
pp. 52-58
Author(s):  
Utpal Kumar Dutta ◽  
Md Monjurul Alam ◽  
Nasima Akhter ◽  
Kanu Lal Saha ◽  
Md Abul Hossain ◽  
...  
Keyword(s):  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Neck Surgery ◽  
Hearing Level ◽  
Canal Wall ◽  
Cross Sectional ◽  
Type Iii ◽  
Hearing Status ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy

Objective: To observe hearing status in case of canal wall down mastoidectomy with type III tympanoplasty. Methods: This was a cross sectional study which was carried out in the departments of Otolaryngology and Head-Neck surgery of Bangabondhu Sheikh Mujib Medical University during the period of July’ 2011 to March’ 2012.A Total 38 patients having cholesteatoma underwent canal down mastoidectomy with type III tympanoplasty,were included in this study. Patients were divided into two groups according to their age. Age belonged to 18 years and more than 18 years were considered as child and adult respectively. Patients were examined thoroughly and preoperative hearing level was assessed by pure tone audiometry one one week before operation. Post operative patients were followed up at regular intervals. Pure tone audiogram (PTA) was done after 8 weeks and hearing assessment was compared by closure of air bone gap. Results: In this study majority of patients were within 13-17 years in child group and 18- 35years in adult group. Most of patients were male.Closure of air-bone gap was significantly higher in adults. Improvement of hearing status was more in adults. Conclusion: CWD mastoidectomy with tympanoplasty not only lowers recurrence rate but also improves hearing status although less likely in child and younger age group than adults. Bangladesh J Otorhinolaryngol; April 2017; 23(1): 52-58

Functional outcomes of tympanoplasty surgery

2016 ◽  
Vol 70 (6) ◽  
pp. 12-19 ◽  
Author(s):  
Izabela Matuszewska ◽  
Paweł Burduk ◽  
Wojciech Kaźmierczak ◽  
Joanna Janiak-Kiszka
Keyword(s):  
Functional Outcomes ◽  
Pure Tone Audiometry ◽  
Type I ◽  
Type Ii ◽  
Hearing Improvement ◽  
Type Iii ◽  
Type Iv ◽  
Ossicular Replacement ◽  
The Mean ◽  
Replacement Prosthesis

Objective: We reviewed functional outcomes of tympanoplasty. Study design: The results of tympanoplastic surgery are changing in time. We present late treatment outcomes among different types of tympanoplasty. Methods: Eighty-six patients who underwent tympanoplasty were enrolled in the study. The results of pure tone audiometry performed 7 days before, then at 3 months, 1 year, and 3 years after the surgery were assessed. Type II tympanoplasty involved implantation of a partial ossicular replacement prosthesis and type III tympanoplasty involved reconstruction with a total ossicular replacement prosthesis and the use of autogenous homogenous material. Statistical analysis was performed. Results: With all four types of tympanoplasty, hearing improvement was achieved at 3 months and 1 year after surgery based on the magnitude of the mean ABG reduction (p<0.001). In patients who underwent type I, type III, and type IV tympanoplasty, the ABG reduction at 3 years after surgery was maintained at the level reported at 3 months and 1 year after surgery (p<0.001). In patients who underwent type II tympanoplasty, however, the mean ABG value was increased at all tested frequencies (p<0.05). The mean ABG values reported 3 years after type II and type III tympanoplasty were similar. Conclusions: Based on the results over time, hearing improvement seems to be less durable after reconstruction with the partial ossicular replacement prosthesis procedure compared to the total ossicular replacement prosthesis procedure.

External Auditory Canal Reconstruction and Mastoid Obliteration Using Modified Palva Flap in Canal Wall Down Mastoidectomy With Tympanoplasty

2019 ◽  
Vol 128 (6_suppl) ◽  
pp. 69S-75S
Author(s):  
Ji-Sun Kim ◽  
Il Gye Lim ◽  
Jeong-Hoon Oh ◽  
Byung Guk Kim ◽  
Ki-Hong Chang
Keyword(s):  
Temporal Bone ◽  
External Auditory Canal ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Canal Wall ◽  
Mastoid Obliteration ◽  
Before And After ◽  
The Status ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy

Objective: To evaluate the effectiveness of a modified Palva flap used for external auditory canal reconstruction and mastoid obliteration in canal wall down mastoidectomy. Methods: We retrospectively analyzed patients who underwent canal wall down mastoidectomy with tympanoplasty using modified Palva flap. All patients underwent pure tone audiometry and temporal bone computed tomography (CT) before surgery, and the same tests were performed in the first year after surgery. The external auditory canal volumes were calculated by summing the areas of each section selected in temporal bone CT. For each patient, the ratio of external auditory canal volume was calculated from CT taken before and after surgery. Results: The mean of external auditory canal volume after canal wall down with a modified Palva flap was about 1.4 times larger than before surgery. The modified Palva flap is effective for the reconstruction of the external auditory canal. Both pure tone audiometry level and air-bone gap showed statistically significant improvement after surgery ( Ps = .001 and .002, respectively). Conclusions: The external auditory canal volume slightly increased, but the status of mastoid obliteration was well maintained 1 year after surgery. The modified Palva flap used in this study is an easy and effective method in external auditory canal reconstruction and mastoid obliteration.

scholarly journals Evaluation of Results of Cartilage Augmentation in Type III Tympanoplasty

2017 ◽  
Vol 25 (3) ◽  
pp. 119-123
Author(s):  
Netra Aniruddha Pathak ◽  
Vidya Vasant Rokade
Keyword(s):  
Pure Tone ◽  
Chronic Otitis Media ◽  
Pure Tone Audiometry ◽  
Canal Wall ◽  
Hearing Results ◽  
Type Iii ◽  
Mixed Hearing Loss ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy ◽  
Conventional Type

Introduction In conventional Type III tympanoplasty, post operative air-bone gap (ABG) is around 10-60dB. This study aimed to assess the hearing results in patients undergoing canal wall down mastoidectomy with cartilage augmented type III tympanoplasty.  Materials and Methods Patients of 6-50 years of age with the diagnosis of Chronic Otitis Media (Squamous) with conductive or mixed hearing loss, requiring canal wall down mastoidectomy and with intact and mobile stapes suprastructure at surgery who underwent cartilage augmentation were included in the study. Pure tone audiometry (PTA) was performed and evaluated. Post- operative hearing was assessed in terms of average air bone gap (ABG) and size of ABG closure.  Results The results concluded that mean of pre and post operative air bone gap were 37.5db and 29.7db respectively with net gain of 7.8db.These differences were significant. Also ABG closure was within 30 db in 28 cases (70%). Discussion The results of this study were compared with other reported series. The mechanical and acoustical aspects of canal wall down surgeries as also the probability of variation in results due to differences in surgical procedures and post-operative fibrosis have been mentioned.   Conclusion There was significant improvement in postoperative hearing after stapes head augmentation in type III tympanoplasty.

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