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

Background: 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. Methods: 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. Results: 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<0.001). Graft success rate being 89.09% and 94.54% in underlay (group A) and interlay (group B) respectively.Conclusions: 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.

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

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20204621 ◽

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

Background: 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.Methods: 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. Results: 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<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.Conclusions: 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.

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

Journal of Nepalgunj Medical College ◽

10.3126/jngmc.v18i1.35181 ◽

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.

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Comparative study between over underlay with classical underlay techniques of tympanoplasty

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20201687 ◽

2020 ◽

Vol 6 (5) ◽

pp. 918

Author(s):

Prashanth Kudure Basavaraj ◽

Manjunatha H. Anandappa ◽

Veena Prabhakaran ◽

Nishtha Sharma ◽

Shreyas Karkala

Keyword(s):

Hearing Loss ◽

Informed Consent ◽

Conductive Hearing Loss ◽

Hearing Threshold ◽

Chronic Otitis Media ◽

Success Rates ◽

Hearing Improvement ◽

Group A ◽

Group B ◽

Conductive Hearing

Background: The objective of the study was to compare the over underlay tympanoplasty technique with classical underlay tympanoplasty in terms of hearing impairment, graft acceptance and complications.Methods: 60 patients of chronic otitis media, mucosal, inactive, aged between 16-60 years who presented to ENT OPD with small, medium, large and subtotal perforations having mild to moderate conductive hearing loss were included in the study. After taking informed consent, patients were randomly divided into 2 groups containing 30 patients each. In group A, graft was placed medial to the handle of malleus and medial to the annulus (underlay technique), while in group B, graft was placed lateral to the handle of malleus and medial to the annulus (over underlay technique). Both groups were reviewed after 6 months. Pre-operative and post-operative air bone gap were compared. Surgery was considered successful based on post-operative graft uptake, hearing improvement and maintenance of middle ear space. Results: In group A, re-perforation was seen in 8 cases (26.7%) whereas only 3 cases (10%) in group B had re-perforation. Medialization was noted among 4 patients in group A (13.3%), and was absent in group B. Lateralization was absent in both the groups. Post-operative hearing threshold in group A was 6.2±4.56 dB and in group B was 11.45±7.38 dB.Conclusions: Over underlay tympanoplasty is a safer technique as compared to classical underlay, showing lower rates of re-perforation or medialization and a significant improvement in hearing. Hence over-underlay is an effective method, having higher success rates.

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comparison of Efficacy of Topical Ciprofloxacin Ear drops (0.6%) Versus a Combination of Systemic with Topical Ciprofloxacin in Treating Chronically Discharging Ears

Esculapio ◽

10.51273/esc20.2516317 ◽

2020 ◽

Vol 16 (03, july 2020-Septmber 2020) ◽

Author(s):

Sarwat Hassan Syed ◽

Damish Arsalan ◽

Ghulam Murtaza ◽

Mohammad Qamar Nasir ◽

Muhammad Awais Amin ◽

...

Keyword(s):

Combination Therapy ◽

Otitis Media ◽

Chronic Otitis Media ◽

Substantial Variation ◽

Treatment Methods ◽

Group A ◽

Group B ◽

Ear Drops

Objective: To compare the efficacy of topical ciprofloxacin alone, versus a combination therapy ofsystemic with topical ciprofloxacin(0.6%) in achieving dry ears in active mucosal chronic otitis media after two weeks of treatment. Methods: After obtaining permission from ethical committee of Hospital, an over-all of 150 patients (with 75 subjects each, divided into two groups) were included in this study. In Group-A: Topical Ciprofloxacin ear drops (0.6%) 3-4 drops were instilled three times a day, 8 hours apart for 2 weeks. In Group-B: Tab Ciprofloxacin 500mg was given twice a day, 12 hours apart for 14 days along with topical Ciprofloxacin ear drops (0.6%) 3 drops were used thrice a day, 8 hours apart for 14 days. Results: Patients ranged between 15-45 years of age. Mean age of the patients was 30.3±7.4 and 29.2±7.7 years. In group-A, there were 41 males (54.7%) and in group-B 49 males (65.3%). Females were 34 (45.3%) in group-A and 27 (36%) in Group-B. Mean duration of ear discharge was 5.3±1.1 months in group-A while 5.5±1.4 months in Group-B. We could not find any substantial variation among the two group in terms of efficacy (p=0.249). Stratification with regard to age, gender and duration of ear discharge was also carried out. Conclusion: Results of this study showed that topical ciprofloxacin ear drops (0.6%) were equally effective as systemic ciprofloxacin combined with topical ciprofloxacin (0.6%), for treating chronically discharging ears. Keywords: CSOM, ciprofloxacin, nature of discharge

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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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Interlay versus underlay type 1 tympanoplasty: a comparative study of the techniques in 100 cases

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20185071 ◽

2018 ◽

Vol 5 (1) ◽

pp. 64

Author(s):

Nitin Sharma ◽

Pritosh Sharma ◽

V. P. Goyal ◽

Kumar Gaurav Sharma

Keyword(s):

Surgical Technique ◽

Prospective Study ◽

Otitis Media ◽

Chronic Otitis Media ◽

Hearing Level ◽

Hearing Improvement ◽

Medical College ◽

Type 1 Tympanoplasty ◽

Central Perforation

Background: Type 1 tympanoplasty is a surgical technique used to restore the integrity of tympanic membrane as well as to improve hearing level in patients with large central perforations (inactive mucosal chronic otitis media).Methods: This is a randomized prospective study of 12 month duration from January 2017 to December 2017 in 100 patients of chronic otitis media inactive mucosal type with large central perforation admitted in the E.N.T department at Geetanjali Medical College and Hospital, Udaipur. Results: The graft uptake rate in the present study was found to be 96% and 90% respectively in interlay and underlay techniques. Post operatively after 12 weeks mean air bone gap was maximum reduced in Interlay tympanoplasty.Conclusions: The present study showed that Interlay technique had a better graft take rate as well as hearing improvement in large central perforation of chronic otitis media than the underlay technique.

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

International Journal of Research and Review ◽

10.52403/ijrr.20210718 ◽

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.

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Prevalence of Chronic Otitis Media among Undernourished Children

Journal of Health and Allied Sciences NU ◽

10.1055/s-0040-1712324 ◽

2020 ◽

Vol 10 (01) ◽

pp. 27-30

Author(s):

Shehanaaz Shajahan ◽

Rajeshwary Aroor

Keyword(s):

Otitis Media ◽

Nutritional Assessment ◽

Chronic Otitis Media ◽

Child Growth ◽

World Health ◽

Normal Children ◽

Suppurative Otitis Media ◽

Growth Standards ◽

Group A ◽

Group B

Abstract Objective This study aimed to identify the role of nutrition in the etiology of chronic suppurative otitis media (CSOM) by comparing the prevalence of CSOM between undernourished children with normal children aged between 10 and 12 years. Materials and Methods A total of 200 children aged between 10 and 12 years studying in government schools were selected for the study. All the children underwent a general and detailed ENT examination in addition to nutritional assessment based on body mass index calculation, using World Health Organization (WHO) Child Growth Standards Chart. The children were divided into two groups: Group A and Group B. Group A consisted of 100 children who were malnourished and Group B consisted of 100 children who were normal. The presence of CSOM in the two groups was noted. Results and Observations Of the total 200 children, 112 were boys (56%) and 88 were girls (44%). Of the 112 boys, 22 (19.64%) had CSOM and out of 88 girls, 24 (27.27%) had CSOM. Of the total 46 children found to have CSOM, 35 children (76.1%) belonged to Group A and 11 children (23.9%) belonged to Group B. Conclusion Our study shows that there is a higher prevalence of CSOM among undernourished children than in normal children. High prevalence of CSOM in undernourished children is a preventable health problem that needs health education and active intervention.

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Endoscopic cartilage tympanoplasty in chronic otitis media

The Journal of Laryngology & Otology ◽

10.1017/s002221511500239x ◽

2015 ◽

Vol 129 (11) ◽

pp. 1073-1077 ◽

Cited By ~ 19

Author(s):

A Özgür ◽

E Dursun ◽

Ö Ç Erdivanli ◽

Z Ö Coşkun ◽

S Terzi ◽

...

Keyword(s):

Otitis Media ◽

Chronic Otitis Media ◽

Type I ◽

Success Rates ◽

Hearing Improvement ◽

Endoscopic Techniques ◽

Cartilage Tympanoplasty ◽

Graft Success ◽

Endoscopic Cartilage Tympanoplasty ◽

Endoscopic Tympanoplasty

AbstractObjectives:The use of endoscopic techniques is becoming more widespread in otological and neuro-otological surgery. One such procedure, endoscopic tympanoplasty, is used in chronic otitis media treatment. This study aimed to analyse the results of endoscopic transcanal cartilage tympanoplasty.Methods:Data of tubotympanic chronic otitis media patients who underwent transcanal endoscopic type I cartilage tympanoplasty between June 2012 and May 2013 were analysed. The main outcome measures were graft success and hearing improvement.Results:Graft success rates were 94.3 per cent and 92.5 per cent at post-operative months one and six, respectively. Post-operative air–bone gap values were significantly improved over pre-operative values (p < 0.01).Conclusion:Transcanal endoscopic type I cartilage tympanoplasty is a minimally invasive, effective and reliable surgical treatment option for chronic otitis media.

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Comparative study of graft materials used in myringoplasty

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20191481 ◽

2019 ◽

Vol 5 (3) ◽

pp. 549

Author(s):

Anchal Gupta ◽

Apurab Gupta ◽

Padam Singh Jamwal

Keyword(s):

Comparative Study ◽

Otitis Media ◽

Chronic Otitis Media ◽

Hearing Improvement ◽

Temporalis Fascia ◽

Suppurative Otitis Media ◽

Central Perforation ◽

Fascia Graft ◽

Group 2 ◽

Group 1

Background: Various graft materials are used for myringoplasty in practice. Present study was done to compare the hearing improvement and graft uptake rate in patients with inactive mucosal type chronic otitis media with central perforation undergoing myringoplasty using either of the two graft materials: temporalis fascia and conchal perichondrium.Methods: Patients with tubotympanic type of chronic suppurative otitis media were selected from patients attending the ENT OPD of SMGS Hospital, Government Medical College, Jammu between July 2016 to March 2018. This study included 100 patients out of which 50 were subjected to myringoplasty with temporalis fascia grafting (Group 1) and remaining 50 to conchal perichondrium grafting (Group 2) using underlay technique. The comparative study was done on following parameters-graft uptake and audiological outcome. Results: 82% patients were of age less than 30 years. The overall male: female ratio was 1.3:1. In Group 1, 76% had gain of 15 db while 12% had gain of >15 db. In Group 2, 72% had gain of 15 db and 8% had gain of >15 db. The graft was intact in 84% patients. 12% of Group 1 patients, showed residual perforation whereas it was 20% in Group 2 patients.Conclusions: The study showed that: the temporalis fascia graft is better than conchal perichondrial graft for closure of perforations in inactive mucosal type of chronic otitis media with central perforation because of maximum hearing improvement and minimal failure rate in group receiving temporalis fascia graft.

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