scholarly journals A study to assess hearing improvement after fat graft myringoplasty

2021 ◽  
Vol 7 (2) ◽  
pp. 303
Author(s):  
Nupur Midha ◽  
Gurbax Singh ◽  
Rachna Dhingra ◽  
Rajwant Kaur
Keyword(s):  
Pure Tone ◽  
Bone Conduction ◽  
Pure Tone Audiometry ◽  
Threshold Level ◽  
Fat Graft ◽  
Hearing Improvement ◽  
Suppurative Otitis Media ◽  
Bone Conduction Threshold ◽  
Tympanic Membrane Perforations ◽  
Number Of Patients

<p class="abstract"><strong>Background:</strong> Tympanic membrane perforations result mainly from infectious and traumatic etiologies. Postoperative outcomes of reconstructive surgeries of hearing mechanism have routinely been assessed by take up rates and air bone gap closure on pure tone testing. The present study was conducted to assess hearing improvement after fat graft myringoplasty.</p><p class="abstract"><strong>Methods:</strong> The present prospective study was conducted from 1<sup>st</sup> January 2017 to 30<sup>th</sup> June 2018. The study population consists of patients of age 18 to 60 years. The subjects with safe or tubotympanic type of chronic suppurative otitis media with small dry central perforation or perforation of the pars tensa less than 3 mm were included in the study. Pure tone audiometry (PTA) was consigned to an audiologist who was blind to the study. Air conduction threshold level was measured at frequencies 0.25 to 8 kHz and bone conduction threshold level was measured at frequencies 0.5 to 4 kHz; average air bone gap of each patient was calculated preoperatively and postoperatively at one and three months at the frequencies 500 Hz, 1000 Hz and 2000 Hz.  </p><p class="abstract"><strong>Results:</strong> Among 30 patients, 15 (50.00%) had pre-operative bone conduction threshold in the range of 0-10 dB HL and rest 15 (50.00%) had between 11-20 dB HL. Majority of them i.e. 20 had post-operative air bone gap in the range of 0-10 dB HL whereas 02 had pre op air bone gap in this range, followed by 07 with air bone gap in the range of 11-20 dB HL as compared to 18 in the pre op and 03 in the range of 21-30 dB HL as compared to 10 in the pre op. Paired t test reveals results are significant.</p><p class="abstract"><strong>Conclusions:</strong> Postoperative audiometry at the end of 1 month revealed majority i.e. 14 had air bone gap in range of 0-10 dB HL thus showing improvement in hearing. Postoperative audiometry at the end of 3 months revealed maximum number of patients i.e. 20 in the range of 0-10 dB HL which showed further improvement in hearing in the form of decrease in air bone gap.</p><p class="Default"> </p>

scholarly journals Correlation of the Puretone Audiometry Findings with Intraoperative Findings in Patients with Chronic Suppurative Otitis Media

2015 ◽  
Vol 2 (1) ◽  
pp. 4
Author(s):  
Devashri Uday Patil ◽  
Kiran S. Burse ◽  
Shreeya Kulkarni ◽  
Vandana Sancheti ◽  
Chaitanya Bharadwaj
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Ossicular Chain ◽  
Chronic Suppurative Otitis Media ◽  
Suppurative Otitis Media ◽  
Number Of Patients ◽  
Operative Findings ◽  
Air Conduction

Chronic suppurative otitis media is one of the common otological conditions in India for which patients seek advice from an otorhinolaryngologist. Chronic suppurative otitis media is recurrent and progressive disease which is characterized with tympanic membrane perforation and suppurative discharge. Pure tone audiometry is the most common test used to evaluate auditory sensitivity. Since hearing loss is a common complication of chronic suppurative otitis media, we designed this study to evaluate preoperative pure tone audiometry findings in patients with chronic suppurative otitis media and its correlation with the intra-operative findings. <strong>Aims and Objectives:</strong> 1] To assess the intra-operative findings in patients with chronic suppurative otitis media. 2] To evaluate the correlation between the preoperative pure tone audiometry findings and intra-operative findings in patients with chronic suppurative otitis media. 3] To assess the type of hearing loss and degree of hearing loss in patients with chronic suppurative otitis media. <strong>Materials and Methods:</strong> This is an Observational study carried over a period of 3 years from August 2011 to August 2013. Total number of patients included in this study was 100. <strong>Result:</strong> Out of 100 patients studied 69 % of patients had Tubo-Tympanic type of CSOM, 31 % of patients had Attico-antral type of CSOM. In patients of Safe CSOM; Central perforation was seen in maximum cases 46.4 %, anterior central perforations was seen in 8.7 % cases, posterior central perforations seen in 20.2 % cases, and subtotal perforations seen in 24.63 % cases. In patients of Unsafe CSOM posterosuperior cholesteatoma was seen in maximum cases 67.74 %, and attic cholesteatoma was seen in 32.2 % cases. In safe CSOM patients all ossicles were intact and mobile whereas in unsafe CSOM patients only 4 patients had intact ossicular chain, while maximum patients had ossicular defect. <strong>Conclusion:</strong> Hearing loss depends on size of perforation. Hearing loss increases as the size of perforation increases. Average air conduction threshold and air bone gap did not differ significantly between various groups of ossicular defect. This shows us that neither air conduction nor air bone gap are reliable parameters on basis of which we can predict ossicular status preoperatively.

scholarly journals Hearing assessment and status of tympanic membrane pre and post-operated tympanoplasty in cases of CSOM.

2020 ◽  
Vol 27 (12) ◽  
pp. 2581-2585
Author(s):  
Tahir Hussain x Tahir Hussain Khan ◽  
Humaira Tahir ◽  
Imran Ali ◽  
Sohail Abdul Malik
Keyword(s):  
Tympanic Membrane ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Medium Size ◽  
P Value ◽  
Safe Procedure ◽  
Hearing Improvement ◽  
Middle Ear Mucosa ◽  
Tympanic Membrane Perforations ◽  
Hearing Assessment

Objectives: To compare assessment of hearing by PTA and status of tympanic membrane by oto-endoscope, pre-operative and post-operative tympanoplasty. Study Design: Retrospective/ Comparative study. Setting: Two different hospitals in Karachi. 1-Social Security Landhi Hospital Karachi. 2- Al-Tibri medical College & Hospital, Old Thana, Malir, Karachi. Period: July 2017 to June 2018. Material & Methods: 76 patients were included for this study with both genders who had dry tympanic membrane perforations. Age ranges between 18 to 40 years. Made two groups A (pre-operative and B (post-operative). In group-A, examined tympanic membrane perforations. 45 patients had small size (25%) perforations, 15 medium size (50%) and 16 subtotal (75%). Hearing assessment done by Pure tone Audiometry (PTA). After 1. 2 and 3 months post-tympanoplasty, examined grafted tympanic membrane and compared pre-operated status of tympanic membrane with post-operated status of tympanic membrane. PTA done after 3 months and compared it with pre-operated PTA. Results: Examination of tympanic membrane before tympanoplasty performed, perforations noted in all patients with different sizes in their tympanic membrane. PTA (pure tone audiometry) advised before tympanoplasty to all patients. Weber test performed on 1st post-operated day, it was lateralized towards operated ear which indicate the safety of inner ear. Post-operated 1, 2 and 3 months examined tympanic membrane with oto-endoscope. Intact grafted tympanic membrane seen in 70 patients after 1 months. After 2 months 72 patients had intact grafted tympanic membrane and after 3 months 73 patients out of 76 patients had intact grafted tympanic membrane. PTA also advised after 3 months of tympanoplasty and compared it with pre-operated pure tone audiometry (PTA). Air conduction (AC) decreased 15.39dB after tympanoplasty. AB-gap reduction 13.95dB seen in 73 patients which showed hearing improvement. P value is < 0.001 significant. Conclusion: Tympanoplasty is a good and safe procedure for hearing improvement by reduction of AB-gap as well as provide protection of middle ear mucosa from infections due to closure of perforations of tympanic membranes.

scholarly journals Correlation between degree of hearing loss and intraoperative findings in tubotympanic type of chronic suppurative otitis media

2018 ◽  
Vol 4 (2) ◽  
pp. 537 ◽  
Author(s):  
Ravi Dudda ◽  
Sowmya Tumkur Rangaiah ◽  
M. Hanumantha Prasad ◽  
Nagavara Kalegowda Balaji
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Otitis Media ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Ossicular Chain ◽  
Chronic Suppurative Otitis Media ◽  
Hearing Improvement ◽  
Suppurative Otitis Media ◽  
Significant Difference

<p class="abstract"><strong>Background:</strong> The aim of tympanoplasty done for tubotympanic type of chronic suppurative otitis media (CSOM) should not only be to achieve a dry ear, but also to give hearing improvement to the patient. Aim of this study was to determine the correlation between size and site of tympanic membrane perforation with degree of hearing loss and correlation between ossicular chain status and degree of hearing loss on pure tone audiometry.</p><p class="abstract"><strong>Methods:</strong> Patients with tubotympanic CSOM with hearing loss upto 60 dBHL undergoing tympanoplasty were examined to know the site and size of tympanic membrane(TM) perforation. Intraoperative findings pertaining to middle ear and ossicles were noted.  </p><p class="abstract"><strong>Results:</strong> Out of 52 patients of tubotympanic type of CSOM, hearing loss was least (31.18±7.46 dBHL) in small perforations of the TM and highest in subtotal perforations (48.74±7.83 dBHL) which was statistically significant. Hearing loss was significantly more in posterior perforation (46.61±7.02 dBHL) than in anterior perforation of TM (32.65±8.77 dBHL).<strong> </strong>There was a statistically significant difference in pure tone average hearing loss between intact ossicle group (32.87±9.77 dBHL)<strong> </strong>and eroded ossicle group (43.39±9.60dBHL). Difference in air bone gap was also significant between intact ossicle group (24.09±9.56 dB) and eroded ossicle group (31.02±9.83 dB). Multiple ossicles were eroded in nineteen patients with incus being the most commonly eroded ossicle.</p><p><strong>Conclusions:</strong> In this study, hearing loss increased with increased size of TM perforation and also with posterior perforation. Incus was found to be the most commonly eroded ossicle. Multiple ossicles were seen eroded most commonly when hearing loss was moderate. The surgeon will be better equipped to do ossiculoplasty in view of these preoperative findings and also to counsel the patient better about their expectation of hearing improvement following surgery. </p>

scholarly journals To assess the hearing improvement in patients of Chronic Otitis Media Tubotympanic type post tympanoplasty

2020 ◽  
Vol 6 (6) ◽  
pp. 305-308
Author(s):  
Harsh Lokhna ◽  
◽  
Sanjay Kumar ◽  
Anshul Bansal ◽  
◽  
...  
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Hearing Improvement ◽  
Middle Ear Mucosa ◽  
Suppurative Otitis Media ◽  
Type 1 Tympanoplasty ◽  
Significant Difference

Aim: To determine hearing improvement in type- 1 tympanoplasty by comparing mean preoperative air bone gap with mean postoperative AB gap. Material and method: Patients clinically diagnosed as 75 cases of Chronic Suppurative Otitis Media Tubotympanic Type Disease presenting to the ENT OPD of Chhatrapati Shivaji Hospital attached to Subharti Medical College, Meerut were taken up for study. Detailed clinical examination and history was taken. Pure tone audiometry was conducted, hearing loss and mean AB Gap was noted pre-operatively. X-Ray mastoid B/L Schuller’s view was done and findings were noted. Tympanoplasty type 1 with or without mastoidectomy was performed. Cortical mastoidectomy with type 1 Tympanoplasty was performed in patients having granulations & polypoidal middle ear mucosa along with sclerotic mastoid. All these patients were followed up post-operatively at 6 weeks. The status of graft uptake was noted. Pure tone audiometry was performed. Hearing loss and mean AB Gap results were compared with pre-operative findings. Results: In our study out of 75 patients, 33 (44%) patients were affected with Right ear and 42 (56%) patients were affected with Left ear. Hearing loss was the chief complaint in all 75 patients (100%) followed by blocking sensation. Post operatively 58 (77.33%) patients had normal hearing followed by 16 (21.33) patients who had mild hearing loss. Only 1 (1.33%) patient had moderately severe hearing loss. Pre-operatively, mean AB Gap was 46.62+/-7.89dB while post-operatively mean AB Gap was 23.43+/-5.52dB with statistically significant difference as p<0.05. Conclusion: In our study, the post-operative Mean AB Gap was improved significantly as compared to preoperative mean AB Gap.

scholarly journals Study of outcome of tympanoplasty with and without mastoid antrum exploration in patients with mucosal CSOM

2019 ◽  
Vol 5 (3) ◽  
pp. 661
Author(s):  
Abhinav Rathi ◽  
Kapil Garg
Keyword(s):  
Uptake Rate ◽  
Pure Tone ◽  
Tuning Fork ◽  
Surgical Intervention ◽  
Pure Tone Audiometry ◽  
Hearing Improvement ◽  
Suppurative Otitis Media ◽  
Standard Medical Treatment ◽  
Systemic Antibiotics ◽  
Mastoid Antrum

<p class="abstract"><strong>Background:</strong> Chronic suppurative otitis media (CSOM) is a major cause of acquired hearing impairment in children. Standard medical treatment of tubotympanic CSOM is aural toilet, topical antibiotics, systemic antibiotics and dry ear precautions. Surgical intervention for safe / tubotympanic CSOM is tympanoplasty. Otologists currently remain divided as to the importance of antrum exploration in the treatment of tubotympanic CSOM. The aim of the study was to evaluate the outcomes of tympanoplasties with and without antrum exploration in cases of tubotympanic CSOM in terms of graft uptake rate and hearing improvement.</p><p class="abstract"><strong>Methods:</strong> The present study included 60 patients of CSOM with central perforation who underwent surgery at JNU IMSRC from January 2016 to July 2016. Detailed history, clinical examination including tuning fork test, pure tone audiometry was done. All patients were followed up for a period of 3 months.  </p><p class="abstract"><strong>Results:</strong> Out of the 60 cases of tubotympanic CSOM graft uptake was seen in 53 cases (88.33%). Graft uptake rate was 96.6% in patients who underwent tympanoplasty with antrum exploration which was significantly higher than those who underwent tympanoplasty alone (80%). Hearing improvement was seen in 93.10% of patients who underwent tympanoplasty with antrum exploration as compared to 83.33% of patients of tympanoplasty which was not statistically significant (p=0.263).</p><strong>Conclusions:</strong>Tympanoplasty with antrum exploration is recommended in all patients of CSOM as it inhances the chances of graft uptake. <p> </p>

scholarly journals Evaluation of hearing loss by pure tone audiometry in chronic suppurative otitis media patients

2018 ◽  
Vol 4 (5) ◽  
pp. 1173
Author(s):  
Prakash S. Handi ◽  
Mallikarjun N. Patil ◽  
K. R. Prasenkumar
Keyword(s):  
Hearing Loss ◽  
Pure Tone ◽  
Bone Conduction ◽  
Pure Tone Audiometry ◽  
Ossicular Chain ◽  
Poor Quality ◽  
Suppurative Otitis Media ◽  
Mixed Hearing Loss ◽  
The Status ◽  
Preoperative Status

<p class="abstract"><strong>Background:</strong> Hearing loss associated with the CSOM affects the patients’ communication with others and results in poor quality of life. Degree and type of hearing loss can be assessed by pure tone audiometry, which helps in predicting the status of tympanic membrane, ossicular chain, and inner ear and also helps in preoperative planning.</p><p class="abstract"><strong>Methods:</strong> Patients with CSOM aged 10 years and above were included in the study. All patients underwent pure tone audiometry. With the help of air and bone conduction threshold, the degree and type of hearing loss in each ear was determined. The data collected was evaluated and results are reported as rates and proportions (%).  </p><p class="abstract"><strong>Results:</strong> Most of the ears (83%) had mild to moderate hearing loss. Average ABG observed was 31 dB. Maximum ABG observed was 55dB on right side and 50 dB on the left side. There was mixed hearing loss in 10.9% cases.</p><p class="abstract"><strong>Conclusions:</strong> This study reinforces the idea of using preoperative pure tone audiometry, which not only helps in planning surgery but also helps in documenting the preoperative status of patients’ sensorineural hearing loss, if present.</p>

scholarly journals Comparative study between fat plug and inlay butterfly cartilage grafts for myringoplasty in adults

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Ahmed Gamal Khafagy ◽  
Mohamed El-Begermy ◽  
Marwa Mohamed El-Begermy ◽  
Pretty O. Afifi
Keyword(s):  
Tympanic Membrane ◽  
Chronic Otitis Media ◽  
Fat Graft ◽  
Cartilage Graft ◽  
Tympanic Membrane Perforations ◽  
Number Of Patients ◽  
Significant Difference ◽  
Hearing Outcomes ◽  
Age Range

Abstract Background This study aims to compare the graft uptake rate and hearing improvement of fat graft versus inlay butterfly tragal cartilage in the repair of perforations in chronic otitis media mucosal in adults. In this retrospective study, twenty-eight patients were included with small dry anteroinferior tympanic membrane perforations (less than 1/3 of the tympanic membrane). The age range was 18 to 44 years old. Myringoplasty was done under general anesthesia for 8 patients with a fat graft (FG) and 20 patients with inlay butterfly cartilage graft (IBCG). Six months postoperatively, a follow-up evaluation was done for successful graft uptake and hearing outcomes. Results The success rate of graft uptake in the first group (fat graft) was 6/8 cases (75%) while in the second group (IBCG) was 19/20 (95%) with no statistically significant difference (P = 0.0148). Also, there was no statistical difference between the two groups as regards postoperative ABG, improvement changes in ABG, and number of patients with improved hearing. Conclusions Inlay butterfly cartilage graft is a useful graft in repairing small tympanic membrane perforations as regard graft take and hearing outcomes.

scholarly journals Pure-tone audiometry without bone-conduction thresholds: using the digits-in-noise test to detect conductive hearing loss

2020 ◽  
Vol 59 (10) ◽  
pp. 801-808 ◽  
Author(s):  
Karina C. De Sousa ◽  
Cas Smits ◽  
David R. Moore ◽  
Hermanus Carel Myburgh ◽  
De Wet Swanepoel
Keyword(s):  
Hearing Loss ◽  
Pure Tone ◽  
Conductive Hearing Loss ◽  
Bone Conduction ◽  
Pure Tone Audiometry ◽  
Noise Test ◽  
Conductive Hearing

The late results of 4000 Hz frequency bone conduction after tympanoplasty

2017 ◽  
Vol 71 (5) ◽  
pp. 12-17
Author(s):  
Joanna Janiak-Kiszka ◽  
Wojciech Kaźmierczak
Keyword(s):  
Bone Conduction ◽  
Organ Of Corti ◽  
Chronic Otitis Media ◽  
Pure Tone Audiometry ◽  
Late Results ◽  
Canal Wall ◽  
Bone Conduction Threshold ◽  
Significant Difference ◽  
Canal Wall Down

Introduction: Surgical treatment of conductive hearing loss runs the risk of damage to the inner ear in the mechanism of acoustic trauma. Aim: The aim of this study was to evaluate the function of the organ of Corti, expressed as bone conduction threshold at the frequency of 4000 Hz for selected operations: mastoidectomy and canal-wall-down procedure. Material and methods: The material was collected from patients with chronic otitis media in the Department of Otolaryngology and ENT Oncology, Collegium Medicum of Nicolaus Copernicus University in Bydgoszcz in 2004–2009. All patients were examined with pure tone audiometry threshold before surgery and at least three years after surgery. The analyzed group of patients was divided into subgroups depending on the type of operation according to To classification and procedures for resection: mastoidectomy and canal-wall-down procedure. The results were statistically analyzed. Results: In the analyzed period of three years after surgery there was no statistically significant difference between groups, although there were higher values for tympanoplasty type 1 with mastoidectomy compared with tympanoplasty type 1 without mastoidectomy - respectively 25.67 dB and 18.53 dB. In the study, there was no statistically significant the difference in bone conduction threshold for frequency 4000 Hz within the type 2 tympanoplasty according to Tosa comparing canal wall-up and canal-wall-down procedure. Conclusions: Mastoidectomy or canal-wall-down procedure do not affect the bone conduction threshold for a frequency of 4000 Hz after tympanoplasty in long-term observation.

scholarly journals A study of hearing improvement after myringoplasties in Bir Hospital, Kathmandu

2012 ◽  
Vol 6 (4) ◽  
pp. 31-35 ◽  
Author(s):  
LK Yadav ◽  
D Shrestha ◽  
J Pradhananga
Keyword(s):  
Otitis Media ◽  
Chronic Suppurative Otitis Media ◽  
Medical Sciences ◽  
Hearing Improvement ◽  
Ear Surgery ◽  
Suppurative Otitis Media ◽  
Pure Tone Audiogram ◽  
Prime Concern ◽  
Number Of Patients ◽  
Air Conduction

Myringoplasty is one of the most common ear surgery performed for chronic suppurative otitis media tubo tympanic type. The prime concern for patients who are willing to undergo myringoplasty is hearing improvement. The aim of this study is to assess the improvement of hearing after myringoplasties for Chronic Suppurative Otitis Media tubo tympanic type. The total number of patients included in the study was 105. Myringoplasties were performed in 129 patients, and only those who had graft uptake i.e. 105, were selected for the study. Age of the patients varied from 13 to 45 years. Pure tone audiogram was done before the operation and four weeks after the operation, and air conduction thresholds were compared. It was found that 83% of the patients had some degree of hearing improvement after the operation. No significant complications were observed except that few patients complained of pain at the site of incision for harvesting the graft. Thus, this study shows that, patients can be assured that the chances of hearing improvement is acceptable and can undergo the operation without fearing complications. Journal of College of Medical Sciences-Nepal,2011,Vol-6,No-4, 31-35 DOI: http://dx.doi.org/10.3126/jcmsn.v6i4.6723

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