scholarly journals Tympanoplasty with and without mastoidectomy in wet ears: a comparative study

Author(s):  
Manish Munjal ◽  
Gopika Talwar ◽  
Shubham Munjal ◽  
Tulika Saggar

<p class="abstract"><strong>Background:</strong> Effect of cortical mastoidectomy on graft uptake and graft mobility and thence shift of hearing thresholds was analysed in tympanoplasty in discharging ears.</p><p class="abstract"><strong>Methods:</strong> In this study, 60 subjects of safe chronic suppurative otitis media were selected from the outpatient clinics of Dayanand Medical College and Hospital, Ludhiana. All were subjected to tympanoplasty utilizing the underlay technique. Mastoid exploration was undertaken in the ears with persistent ear discharge.  </p><p class="abstract"><strong>Results:</strong> Cortical mastoidectomy performed in 20 (33.3%) out of 60 patients and most of cases were done in superiorly based/superior cuff tympanoplasty group in our study. No statistically significance found between cortical mastoidectomy and different flap technique. Mean hearing gain is more with cortical mastoidectomy (16.85 dB) than without cortical mastoidectomy (13.05 dB) and graft uptake was 97.5% without cortical and 95% with cortical mastoidectomy.</p><p class="abstract"><strong>Conclusions:</strong> There was higher mean gain in thresholds of hearing in subjects with cortical mastoidectomy with tympanoplasty though uptake was almost equal to those without mastoidectomy.</p>

Author(s):  
Ritesh Mahajan ◽  
Nidhi Abraham ◽  
Nagaraj T. M.

<p class="abstract"><strong>Background:</strong> 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.</p><p class="abstract"><strong>Methods:</strong> 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.  </p><p class="abstract"><strong>Results:</strong> 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.</p><p class="abstract"><strong>Conclusions:</strong> 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.</p>


2019 ◽  
Vol 46 (2) ◽  
pp. 7-9
Author(s):  
Rifat Nousin Shumi ◽  
Abdullah Siddiqe ◽  
Arefa Akter

Chronic suppurative otitis media (CSOM) is a prevailing and notorious infection in developing countries causing serious local damage and threatening complications. The purpose of the present study was determine the microbiological profile of isolates from discharge in CSOM. This study was conducted at out-patient department of ENT at Rajshahi Medical College Hospital, Rajshahi from January 2014 to December 2014. Samples were taken from 185 patients (both male and female) in all age groups suffering from chronic suppurative otitis media. Their Gram staining, culture, and biochemical tests were carried out to identify the organisms. It showed the predominance by staphylococcus aereus (29.13%), followed by Pseudomonas Aeruginosa (22.83%), Streptococcus Pyogen (14.96%), E.Coli (9.44%), Proteus Mirabilis (6.29%), Klebsiella Pneumonia ( 4.72%). Bangladesh Med J. 2017 May; 46 (2): 7-9


1929 ◽  
Vol 25 (7-8) ◽  
pp. 802-805
Author(s):  
Z. I. Wolfson ◽  
O. A. Vasilieva

Patients with chronic damage to the ears have been visiting our outpatient clinics for years without results, undergoing all kinds of therapeutic interventions and, in the end, lose all hope of a cure. It remains, as ultimum refugium, surgical intervention in the form of a radical operation, but the latter does not give us confidence that we will free the patient from his suffering. Therefore, the attention of otiatrists has long been directed towards finding new ways to treat chronic suppurative otitis media.


2021 ◽  
Vol 37 (3) ◽  
Author(s):  
Mst. Romena Khatun ◽  
Kh. Md. Faisal Alam ◽  
Mahmuda Naznin ◽  
Md. Abdus Salam

Objectives: Chronic suppurative otitis media is a major cause of acquired hearing impairment, especially in children of developing countries. The study sought to explore the bacteriological profile and their antimicrobial susceptibility among patients of chronic suppurative otitis media from a tertiary care hospital in Bangladesh. Methods: A cross sectional microbiological study was conducted at the Department of Microbiology, Rajshahi Medical College, Bangladesh from January to December 2019. Aural swabs were collected aseptically from clinically suspected patients irrespective of age and gender attending the ear, nose and throat outpatient department of Rajshahi Medical College Hospital. Aerobic bacterial culture was done and isolates were identified through standard bacteriological identification scheme. Antimicrobial susceptibility testing of isolates was done by modified Kirby-Bauer disk diffusion method following Clinical and Laboratory Standards Institute guidelines. Results: Of 96 swabs, culture yielded a total of 73 bacterial isolates from 68(70.8%) culture-positive plates including 63 (65.6%) unimicrobial and 5 (5.2%) polymicrobial (mixed growth of a pair of bacteria) growths. Frequency distribution revealed, 40(55%) gram-negative and 33(45%) gram-positive bacteria with Staphylococcus aureus was the leading isolate (37%) followed by Pseudomonas aeruginosa (31.5%), Escherichia coli (13.7%), coagulase-negative Staphylococcus (8.2%), Klebsiella pneumoniae (5.5%) and Proteus spp. (4.1%). Gram-positive bacteria were found to be highly susceptible (100%) to Linezolid and Vancomycin followed by Imipenem (83 to 96.3%), while moderate to high resistance (44 to 67%) was observed against Ciprofloxacin, Ceftriaxone, Ceftazidime, Amoxicillin/Clavulanate and Clindamycin. For gram-negative bacteria, susceptibility ranged from 67 to 100% to Imipenem, 67 to 96% to Piperacillin/Tazobactam and 67 to 83% to Gentamicin, while moderate to high resistance (50 to 75%) was observed against Ciprofloxacin, Ceftriaxone, Ceftazidime and Amoxicillin/Clavulanate. Conclusion: Moderate to high level of multidrug-resistance especially to 3rd generation cephalosporins, Ciprofloxacin and Amoxicillin/Clavulanate is an alarming situation. It warns reinforcement of judicious antibiotic prescription and introduction of antibiotic stewardship program in the tertiary care hospitals. doi: https://doi.org/10.12669/pjms.37.3.3942 How to cite this:Khatun MR, Alam KMF, Naznin M, Salam MA. Microbiology of Chronic Suppurative Otitis Media: An update from a Tertiary Care Hospital in Bangladesh. Pak J Med Sci. 2021;37(3):---------. doi: https://doi.org/10.12669/pjms.37.3.3942 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Mediscope ◽  
2017 ◽  
Vol 4 (2) ◽  
pp. 25-28
Author(s):  
MS Islam ◽  
MA Gafur ◽  
L Noor ◽  
MR Islam

To study the clinical presentations of chronic suppurative otitis media (CSOM) with cholesteatoma and its complication, 96 patients with CSOM from ENT department of a medical college hospital during January 2011 to January 2014 were included in this study. The highest number of cases belonged to the age group of 11-20 years (55.2%), and the number of males and females was 67.2% and 32.8%, respectively. Almost all the patients presented with multiple symptoms. The most common symptoms were discharge from ear(s) (100.0%), hearing impairment (83.3%), earache (15.6%), fleshy mass in ear(s), etc. Of the patients, 67.9% cases were without complication, 26.1% with extracranial complication and 6.3% with intracranial complication. All the cases had a perforation either in the posterior superior marginal (66.5%) or in the attic region (33.5%). Most of the patients were having unilateral CSOM with cholesteatoma, in the right side (64.3%), left side (35.7%), and a few (4.2%) bilateral involvement. Although 83.3% of the patients complained of deafness, audiometric tests were done in 93.7% of the patients excluding 6.4% who had intracranial complication. All of them (93.7% tested) had developed deafness; mild deafness (20.0%), moderate deafness (77.8%), and severe deafness (2.2%). In conclusion, the pattern of clinical presentation and complication of CSOM with cholesteatoma in rural setting may be similar with the pattern involving urban population and early diagnosis of CSOM with cholesteatoma by taking proper history and clinical examination, and timely surgical intervention may be helpful to eradicate the disease and prevent complications.Mediscope Vol. 4, No. 2: Jul 2017, Page 25-28


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