scholarly journals Assessment of the outcome of myringoplasty with cortical mastoidectomy in dry and wet mucosal type of chronic otitis media

2020 ◽  
Vol 6 (11) ◽  
pp. 2001
Author(s):  
Sreeshma Balan ◽  
Prakash M. D.
Keyword(s):  
Success Rate ◽  
Otitis Media ◽  
Statistical Significance ◽  
Chronic Otitis Media ◽  
P Value ◽  
Hearing Improvement ◽  
Cortical Mastoidectomy ◽  
Significant Difference ◽  
Group A ◽  
Group B

<p class="abstract"><strong>Background:</strong> Chronic otitis media (COM) is an inflammatory process in the middle ear space that results in long-term changes in the tympanic membrane including atelectasis, dimeric-membrane formation, perforation, tympanosclerosis, retraction pocket or cholesteatoma. COM can be classified into healed, inactive (mucosal or squamosal), active (mucosal or squamosal). Myringoplasty is tympanoplasty without ossicular reconstruction. Cortical mastoidectomy is usually accompanied by tympanoplasty. Aim was to assess and compare the efficacy of myringoplasty with cortical mastoidectomy in dry and wet mucosal type of COM, in terms of graft uptake and hearing improvement.</p><p class="abstract"><strong>Methods:</strong> A prospective study, where 30 patients each of wet and dry mucosal-type COM were included. Patients underwent myringoplasty with cortical mastoidectomy. All were followed up for 6 months, both the groups were statistically compared.  </p><p class="abstract"><strong>Results:</strong> In our study, mean age of patients in group A (wet COM) was 34.13 years and group B (dry COM) was 33.36 years. Group A had success rate of 90% and group B had success rate of 86.6%. There was no statistical significance (p value- 0.53) on comparing both groups with respect to graft uptake. There was significant hearing improvement post-operatively in both the groups (p&lt;0.05). However, there was no significant difference between the groups (p value- 0.66). This shows that presence of discharge at the time of surgery does not interfere with the results of cortical mastoidectomy with myringoplasty.</p><p class="abstract"><strong>Conclusions:</strong> We conclude that, there is good outcome in both wet and dry COM following myringoplasty with cortical mastoidectomy with respect to graft uptake and hearing improvement.</p>

scholarly journals Role of Cortical Mastoidectomy in the Management of Mucosal Chronic Suppurative Otitis Media

2021 ◽  
Vol 8 (7) ◽  
pp. 136-141
Author(s):  
Sumit Sharma ◽  
Chhavi Gupta ◽  
Richa Singh
Keyword(s):  
Otitis Media ◽  
Chronic Suppurative Otitis Media ◽  
Hearing Improvement ◽  
Suppurative Otitis Media ◽  
Type 1 Tympanoplasty ◽  
Cortical Mastoidectomy ◽  
Significant Difference ◽  
Group A ◽  
Group B

This is a comparative study done to evaluate outcome of type 1 Tympanoplasty with and without mastoidectomy in terms of hearing improvement and graft uptake. This is a prospective study done in 100 patients at a tertiary care referral centre during November 2018 to march 2020. Patients were divided in two groups, Group A consists of 50 patients in whom type 1 Tympanoplasty was done and in Group B 50 patients were there who had undergone Type 1 Tympanoplasty with cortical mastoidectomy. Patients were evaluated postoperatively at 2nd wk, 4th wk, 2nd month and 3rd month for graft uptake, disease clearance, and hearing improvement. PTA was done at 3rd month postoperatively. In our study we observed graft uptake in 94% of patients in Group A as compared to 98% of patients in Group B and in terms of hearing improvement there is not much difference in both the groups i.e. in Group A it is 13.996 ± 4.235 while in Group B it is 14.172 ± 5.381 P value is 1 which means there is no statistically significant difference in two groups. Though better results were observed for cortical mastoidectomy with Type 1 Tympanoplasty than Type 1 Tympanoplasty alone but the difference was insignificant. Keywords: Cortical Mastoidectomy; Mucosal Chronic Suppurative Otitis Media; CSOM.

scholarly journals Role of Cortical Mastoidectomy in the Management of Safe Chronic Otitis Media

2020 ◽  
Vol 18 (1) ◽  
pp. 44-48
Author(s):  
Lok Ram Verma ◽  
Dhundi Raj Paudel
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Inactive Disease ◽  
Type I ◽  
Hearing Improvement ◽  
Beneficial Effects ◽  
Cortical Mastoidectomy ◽  
Group A ◽  
Group B

Introduction: Role of cortical mastoidectomy in tympanoplasty for Chronic Otitis Media Mucosal inactive disease is controversial. Some arguments are in favor and suggest that cortical mastoidectomy increases the air reservoir in the mastoid and also help in achieving the patency of aditus but others believe that the ingrowths of squamous epithelium, potential for injury to the inner ear structures and facial nerve during mastoid surgery outweighs the beneficial effects on tympanic membrane healing. Aims: To assess the hearing improvement and graft uptake in patients undergoing Tympanoplasty and Tympano-mastoidectomy in chronic otitis media mucosal inactive disease. Methods: This was a comparative study comprises of 50 patients with Chronic Otitis Media Mucosal inactive ear, conducted in the patients attending the department of ENT in NGMC teaching hospital from Nov 2017 to May 2019. All cases were operated during a period of one half year. 25 patients were selected for tympanoplasty (Group A) and 25 patients were selected for Tympanoplasty with cortical mastoidectomy (Group B). Results: There were 14(28%) male and 36(72%) female, with mean age of 28. 36 years, ranging from minimum of 13 years to maximum 56 years. The postoperative audiograms were recorded after 3 months. Type I tympanoplasty with cortical mastoidectomy has better graft uptake (96%) as compared to without mastoidectomy (84%). Post-operative hearing improvement is almost equal in tympano-mastoidectomy (13.24 dB) and tympanoplasty (13.04 dB). Conclusion: Post-operative hearing gain almost equal in both study group but graft uptake was better with tympano-mastoidectomy then tympanoplasty alone in present study.

scholarly journals Tympanoplasty with and without cortical mastoidectomy in treatment of inactive mucosal chronic otitis media

2019 ◽  
Vol 5 (4) ◽  
pp. 858
Author(s):  
Divya Aggarwal ◽  
Sandeep Vemu ◽  
Sunil Kapur
Keyword(s):  
Otitis Media ◽  
Uptake Rate ◽  
Controlled Trial ◽  
Statistical Significance ◽  
Chronic Otitis Media ◽  
Sampling Technique ◽  
Simple Random Sampling ◽  
P Value ◽  
Cortical Mastoidectomy ◽  
Significant Difference

<p class="abstract"><strong>Background:</strong> Tympano-mastoidectomy has been found to be an effective method of treatment of chronic ear infection, but the effect of mastoidectomy on patients without evidence of active infectious disease in mastoid remains highly debated and unproven. Analyse the surgical outcomes of repair of uncomplicated tympanic membrane perforations with tympanoplasty alone and tympanoplasty combined with mastoidectomy.</p><p class="abstract"><strong>Methods:</strong> The present study was a prospective, comparative, randomized controlled trial in which 60 patients 30 in each groups via simple random sampling technique underwent tympanoplasty with cortical mastoidectomy. Temporalis fascia was used as graft in all the cases. All the surgeries were done by post aural route and underlay technique was used in all cases.  </p><p class="abstract"><strong>Results:</strong> The overall graft uptake rate in our study was 88.33%. The graft uptake rate in tympanoplasty group was 87% and 90% in the tympanoplasty with cortical mastoidectomy group. There was no significant difference in the graft uptake rates of the two groups. There was no statistical significance between the two groups as p&gt;0.05, suggesting that mastoidectomy when combined with tympanoplasty offers no benefit over tympanoplasty alone. There was no significant difference in hearing gain between the two groups as p value obtained was &gt;0.05.</p><p class="abstract"><strong>Conclusions:</strong> Tympanoplasty alone is sufficient in patients with chronic inactive mucosal otitis media, as the results of the graft uptake and hearing improvement show no significant difference between the tympanoplasty group and the tympanoplasty with cortical mastoidectomy group.</p>

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

2017 ◽  
Vol 3 (3) ◽  
pp. 705 ◽  
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

<p class="abstract"><strong>Background:</strong> 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.</p><p class="abstract"><strong>Methods:</strong> 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.  </p><p class="abstract"><strong>Results:</strong> 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&gt;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&gt;0.05).</p><p><strong>Conclusions:</strong> 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. </p>

scholarly journals Comparative study showing relevance of prosthesis diameter and hearing outcome in stapes surgery

2020 ◽  
Vol 6 (8) ◽  
pp. 1464
Author(s):  
Udayanila Thangavel ◽  
Harish Narasing Katakdhond ◽  
Deepak Dalmia ◽  
Narsinha Davange ◽  
Parth Patni ◽  
...  
Keyword(s):  
Controlled Trial ◽  
T Test ◽  
P Value ◽  
Hearing Improvement ◽  
Hearing Outcome ◽  
Teflon Piston ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
The Individual

<p class="abstract"><strong>Background:</strong> Otosclerosis presents as conductive hearing loss, stapedotomy is the treatment for otosclerosis, and different sizes of piston diameter are available for the procedure. Aims and objectives were to study and compare hearing improvement between the 0.4 and 0.6 mm sizes of teflon piston in stapedotomy.</p><p class="abstract"><strong>Methods:</strong> It was a prospective randomized controlled trial. Patients fulfilling inclusion criteria were subjected for small fenestra stapedotomy. Patients were divided into two groups after randomization into group A (with 0.4 mm piston diameter) and group B (with 0.6 mm piston diameter). The hearing outcome with standard audiological assessment was performed at one month and six months postoperatively.  </p><p class="abstract"><strong>Results:</strong> Comparison of 1 month AB gap among the patients with 0.4 mm piston and 0.6 mm piston showed that there was no statistically significant difference among both the groups of patients (independent t test p value=0.699). Comparison of 6 month AB gap among the patients with 0.4 mm piston and 0.6 mm piston showed that there was no statistically significant difference among both the groups of patients (independent t test p value=0.54).</p><p class="abstract"><strong>Conclusions:</strong> There was no significant difference in hearing improvement among the individual methods (piston size 0.4 and 0.6) with each other both in 1 month post-operative and 6 month post-operative follow up. Hence, we conclude that there is no relevance of different diameter of teflon piston prosthesis (0.4 mm versus 0.6 mm) as far as hearing outcome is concerned.</p>

scholarly journals Outcome of ear surgeries in dry and wet ear

2017 ◽  
Vol 3 (3) ◽  
pp. 562 ◽  
Author(s):  
Shreyash C. S. ◽  
Rajneesh . ◽  
Rahul S.
Keyword(s):  
Success Rate ◽  
Otitis Media ◽  
Chronic Otitis Media ◽  
Success Rates ◽  
Hearing Improvement ◽  
Suppurative Otitis Media ◽  
Time Of Surgery ◽  
Type 1 Tympanoplasty ◽  
Cortical Mastoidectomy

<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>

scholarly journals Outcome of underlay versus interlay tympanoplasty in patients with inactive mucosal chronic otitis media with large central perforation: a retrospective comparative study

2020 ◽  
Vol 7 (1) ◽  
pp. 121
Author(s):  
Rajneesh . ◽  
Dinesh Valse ◽  
Shradha Pawar ◽  
Anil Kumar Doddamani
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Hearing Improvement ◽  
Tertiary Referral Hospital ◽  
Hospital Department ◽  
Central Perforation ◽  
Group A ◽  
Graft Success ◽  
Group B ◽  
Retrospective Comparative Study

<p class="abstract"><strong>Background:</strong> Aim and objective were to study the outcome of underlay versus interlay tympanoplasty in patients with inactive mucosal chronic otitis media with large central perforations in terms of graft uptake rate and hearing improvement.  </p><p class="abstract"><strong>Methods:</strong> The present study was conducted retrospectively on 110 patients of inactive mucosal chronic otitis media with large central perforation, 55 patients selected from each group undergoing underlay or interlay technique in a tertiary referral hospital, Department of ENT, ESIC Kalaburagi, Karnataka, from February 1 2018 to January 31, 2020.  </p><p class="abstract"><strong>Results:</strong> Total 110 patients were included in the study. Male:female ratio was 1:2.2. The age group in this study ranged from 13-50 years of age. Preoperative mean air bone gap in groups A and B was 30.28±6.62, and 30.18±6.87 dB and postoperative mean air bone gap was 19.44±7.66 and 15.13±6.3 dB. In both the groups a significant mean reduction in air bone gap was observed. Mean reduction was maximum in group B. Statistically, intergroup difference in reduction in air bone gap was highly significant (p&lt;0.001). Graft success rate being 89.09% and 94.54% in underlay (group A) and interlay (group B) respectively.</p><p class="abstract"><strong>Conclusions:</strong> Interlay is a better technique than underlay in chronic otitis media inactive mucosal disease with large central perforation in terms of hearing improvement and graft uptake.  </p>

scholarly journals Comparison of Propofol Vs Thiopentone in Post Operative Nausea and Vomiting in Patients Undergoing Laparoscopic Cholecystectomy

2019 ◽  
Vol 18 (1) ◽  
pp. 23-29
Author(s):  
Bhuwan Raj Kunwar ◽  
Thaneshowr Rijal ◽  
Puja Thapa ◽  
Mallika Rayamajhi ◽  
Biswo Ram Amatya
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Statistical Significance ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
P Value ◽  
Fisher Exact Test ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Post Operative Nausea

Introduction: Postoperative Nausea and Vomiting (PONV) is one of the commonest causes of significant morbidity in the patients after laparoscopic cholecystectomy. The purpose of this study was to compare the incidence of PONV when propofol and thiopentone were used as induction agents during laparoscopic cholecystectomy. Methods: A prospective, randomised comparative study was conducted in operation theatre at a tertiary level referral hospital of Nepal. A sample size of 100 ASA I - II patients aged between 18 and 70 years were included and scheduled for elective laparoscopic cholecystectomy. The study population were divided into two groups: Group A (Propofol), n = 50 and Group B (Thiopentone), n = 50. These patients were followed up for the first 24 hours postoperatively for any PONV at 0-6 hrs, 6-12 hrs, 12-24 hrs. Results: Out of the 100 patients, PONV was observed almost similar in both groups. i.e. group A (Propofol) n = 31, (62%) and group B (Thiopentone) n = 26 (52%) with no statistical significance (p value = 0.1998) within the first 24 hours postoperatively in both groups; and no significant difference was observed at the different time intervals viz. at 0-6 hrs (p value 0.262): Group A = 45%; Group B = 40%; 6-12 hrs (p value 0.781): Group A = 17.5%, Group B = 22.5%; 12-24 hrs (p value 1.000) Group A = 0%; Group B = 2.5% when using the Fisher exact test. The mean ages for development of PONV in these two groups were: Group A = 40 years and Group B = 38 years. The p-value was 0.5125 which showed no statistical significance. In our study 76% (n = 38) were females and 24% (n = 12) were males in Group A; while 70% (n = 35) were females and 30% (n = 15) males in Group B. However, there was no statistical difference between the two groups in terms of PONV. Conclusions: The study showed that there was a high incidence of PONV during laparoscopic cholecystectomy. However, there was no significant difference in the incidence of PONV when propofol or thiopentone was used.  

scholarly journals A comparative study in the use of topical mitomycin-C versus nasolacrimal stent in endoscopic dacryocystorhinostomy for chronic dacryocystitis

2017 ◽  
Vol 4 (1) ◽  
pp. 176 ◽  
Author(s):  
Vikas Gupta ◽  
Inderdeep Singh ◽  
Gunjan Dwivedi ◽  
Sunil Goyal ◽  
Manoj Kumar ◽  
...  
Keyword(s):  
Success Rate ◽  
Mitomycin C ◽  
P Value ◽  
Lacrimal Sac ◽  
Endoscopic Dacryocystorhinostomy ◽  
Chronic Dacryocystitis ◽  
Significant Difference ◽  
Silicone Stent ◽  
Group A ◽  
Group B

<p class="abstract"><strong>Background:</strong> Inflammation of the lacrimal sac and duct is a common and unpleasant condition, leading to troublesome epiphora and recurrent dacryocystitis. Surgery is the preferred treatment modality of chronic dacryocystitis which can be performed by external approach or endoscopic nasal approach. Endoscopic dacrycocystorhinostomy (EnDCR) is now a well-established procedure to relieve nasolacrimal duct obstruction, becoming ENT surgeons’ domain. The aim of this study is to assess the efficacy and compare results of intraoperative use of nasolacrimal stent in comparison of mitomycin-C (MMC) in endoscopic dacryocystorhinostomy.</p><p class="abstract"><strong>Methods:</strong> A prospective study of 56 patients with acquired NLDO with epiphora and recurrent dacryocystitis who were evaluated and managed between Oct 2014 and Oct 2016. All patients were offered surgical line of management by endoscopic route. They were randomly assigned into two groups-mitomycin-C group (Group A) and silastic nasolacrimal stenting (Group B). 46 patients who matched inclusion criteria’s were included in the study after formal evaluation by ENT surgeon and Ophthalmologist. 26 patients underwent endoscopic dacryocystorhinostomy with Mitomycin-C application intra – op, 20 patients underwent nasolacrimal silicone stent placement.  </p><p class="abstract"><strong>Results:</strong> At 6-month follow-up visit, the management was considered successful if the lacrimal sac irrigation succeeded with relief of symptoms. The success rate in Group A was 92.30%. Group B had 85% success rate. However, no significant (p value=0.37) was noticed between two groups.</p><p><strong>Conclusions:</strong> Despite, no significant difference in outcome between two modalities, there is a trend towards the better outcome with use of mitomycin-C. Mitomycin-C is a safe, effective, and economical adjuvant in endoscopic DCR assisting in improved outcomes of surgery. </p>

scholarly journals Benefit of Tympanoplasty with or without Cortical Mastoidectomy in Active Mucosal Otitis Media – A Comparative Study

2019 ◽  
Vol 27 (1) ◽  
Author(s):  
Anushree Raviprakash Bajaj ◽  
Shahnaz Sheikh ◽  
Samir Joshi ◽  
Bhalchandra Paike
Keyword(s):  
Otitis Media ◽  
Hearing Threshold ◽  
Chronic Otitis Media ◽  
Research Articles ◽  
Hearing Improvement ◽  
Post Operative Period ◽  
Cortical Mastoidectomy ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Introduction: Chronic otitis media (COM) is amongst the most common diseases treated by ENT surgeons in India. It has been advocated in lot of research articles that there is no significant difference in tympanoplasty done in active and inactive COM. The objective was to see if cortical mastoidectomy in cases of active mucosal COM, improves the success rate of tympanoplasty measured as per the following parameters: improvement in the hearing threshold by 15 dB, increased graft uptake and reduction in retraction of tympanic membrane in post operative period. Materials and Methods:             This study comprises of 120 patients coming to the ENT OPD from October 2016 to October 2017 with active mucosal COM with central perforation requiring tympanoplasty. These patients were randomly assigned to two groups: Group 1 of 60 subjects in which tympanoplasty without mastoidectomy was done, Group 2 of 60 subjects in which tympanoplasty with mastoidectomy was done. Patients were evaluated after a post operative period of 3 months. Results: The Results were the hearing improvement was 73.33% in group 1 while 83.33% in group 2, graft uptake was 63.33% in group 1 and 80% in group 2, graft retraction was 33.33% and 23.33% in group 1 and group 2 respectively. Conclusion: There was statistically significant difference in results in group with and without mastoidectomy in active mucosal chronic otitis media with respect to graft uptake and improved hearing.

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