A comparative study of the outcome of tympanoplasty in dry and wet ear

Background: Many factors which influence the success rate of tympanic membrane closure, including age of the patient, size of the perforation, duration of the ear discharge, the presence or absence of infective discharge at the time of surgery. Aim was to find the effect of this discharge from the ear on the success of tympanoplasty. Methods: This is prospective study which was conducted on 100 cases with 50 patients each in dry and wet ear group. The study was conducted on patients of age 6 years to 60 years and of either sex presenting with chronic otitis media. Results: Ear discharge for less than 10 years, 78% in dry ear group and 81% in wet ear group. Around 64% had hearing impairment for<5 years in dry ear group and 60% in wet ear group. The size of perforation in dry ear group, medium size perforation was found predominant 46%, large in 42% and small in 12% patients. In wet ear group 46% patients had medium, 16% patients small and 38% patient’s large perforation. Hearing improvement seen in 35 (70%) cases and worsening in 3 (6%) cases in dry ear group and 38 (76%) hearing improvement, 3 (6%) worsening in wet ear group.Conclusions: Graft failure was 4(8%) in dry ear and 5(10%) in wet ear. Hearing worsened in 6% cases in dry and wet ear group both. No other complications were seen in patients during follow up.

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Prospective study on technique of graft fishing with anterior tucking in type 1 tympanoplasty and its hearing outcome

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20205067 ◽

2020 ◽

Vol 6 (12) ◽

pp. 2243

Author(s):

Digant Patni ◽

Ankit Mishra ◽

Dinesh Patel ◽

Vishal R. Munjal

Keyword(s):

Hearing Loss ◽

Prospective Study ◽

Success Rate ◽

Chronic Otitis Media ◽

Type I ◽

Graft Material ◽

Temporalis Fascia ◽

Fascia Graft ◽

Conductive Hearing

Background: Chronic otitis media (COM) is a common health problem in developing world and has a major impact on patient in the form of hearing loss. Temporalis fascia is commonest graft material used for tympanoplasty as it is readily available through same post aural incision. The study was conducted with an aim to find out the effectiveness of fishing technique and anterior tucking in terms of graft stability, graft uptake, hearing improvement and complications.Methods: The present study is prospective study conducted on patients with complains of otorrhea and hearing loss, of age between 15 to 60 years, during the period January 2017 to June 2018. Patients with inactive mucosal COM and pure conductive hearing loss who underwent type-I tympanoplasty were included. Patients with cholesteatoma, ossicular pathology, trauma, mixed or sensorineural hearing loss, were excluded. Paired ‘t’ test was applied to compare preoperative and postoperative mean air-bone gap.Results: In our study total 123 patients were analysed for the follow-up period of 6 months and it was observed that graft was well accepted in 93.5% patients while in 4.8% patients residual anterior perforation was found and in 1.7% patients the graft was completely rejected, showing an overall success rate at the end of 6 months follow-up to be 93.5%. There was a statistically significant improvement in hearing gain at the end of 6 months follow-up (p<0.05).Conclusions: Tympanoplasty with temporalis fascia graft using fishing and anterior tucking technique gave good dimensional stability to graft, preventing lateralization / medialization of graft. The superiorly based circumferential flap allowed for 360 degree placement of graft and anterior tucking, with overall high success rate and lower rate of complications and graft rejection.

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Comparative study between endoscopic cartilage myringoplasty and endoscopic temporalis fascia myringoplasty

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20185116 ◽

2018 ◽

Vol 5 (1) ◽

pp. 24 ◽

Cited By ~ 1

Author(s):

P. Chozhan ◽

M. Sankara Subramanian ◽

D. Kannathal ◽

R. Malarvizhi

Keyword(s):

Comparative Study ◽

Prospective Study ◽

Temporalis Fascia ◽

Ear Surgery ◽

Medical College ◽

The World ◽

Prospective Comparative Study ◽

Patient Series ◽

A Prospective Study

Background: Myringoplasty is a common ear surgery performed all over the world. This study is focused on prospective comparative study using two different graft materials.Methods: This was a prospective study done in the Department of ENT Stanley Medical College, Chennai during the period from March 2013 to September 2013. Sample size was 60 patients. Follow up was done till 6 months. Results: Graft acceptance was achieved in 28 patients (93%) who underwent palisade cartilage myringoplasty, whereas it was achieved in 24 patients (80%) in the temporalis fascia myringoplasty group.Conclusions: The outcomes in our patient series indicate that cartilage myringoplasty achieves good results. Cartilage, a very effective material for the reconstruction of the TM and grafts can provide an excellent anatomical result, perfect stability and good functional outcome.

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TO ASSESS THE OUTCOME OF ENDOSCOPIC INTERLAY TYMPANOPLASTY IN TERTIARY CARE CENTER

10.36106/ijsr/5114125 ◽

2021 ◽

pp. 73-75

Author(s):

Pasunuti Shravya ◽

Jyothi Swarup ◽

Vigeshwar RK

Keyword(s):

Success Rate ◽

Otitis Media ◽

Care Center ◽

Tertiary Care ◽

Chronic Otitis Media ◽

Hearing Improvement ◽

Suppurative Otitis Media ◽

Conducting Mechanism ◽

Conductive Hearing ◽

Middle Ear Cleft

Background: Chronic otitis media is an inammatory process in middle ear cleft which is treated by a common otological procedure tympanoplasty to reconstruct the tympanic membrane and to restore sound-conducting mechanism. Rigid endoscope in transcanal interlay tympanoplasty has signicant advantage as it provides magnied, and wide angle view, with better success rate and postoperative hearing gain. The Aims and objectives were to assess the outcome of endoscopic interlay tympanoplasty, in terms of graft uptake, hearing improvement and rate of complications in cases of inactive mucosal chronic suppurative otitis media. Methods: This prospective study was conducted for 1 year at our institution in 50 patients having conductive hearing loss with dry, central perforation. All patients underwent transcanal endoscopic interlay tympanoplasty and were followed up for 3months to determine the graft uptake, hearing improvement and rate of complications. Results: Graft uptake rate in the present study was found to be 98% with residual perforation as a complication in 2% patients and no other complications were encountered. Post operatively air bone gap (ABG) after 12 weeks found to be < 20 dB ABG in 84% patients. Conclusion: Endoscopic interlay tympanoplasty is a effective method with high success rate both in terms of graft uptake as well as post operative hearing improvement and can be implemented in all cases of inactive mucosal COM.

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TREATMENT OF TRIGGER FINGERS BY INJECTION OF METHYLPREDNISOLONE ACETATE AND LIDOCAINE (DEPO-MEDROL®)

Hand Surgery ◽

10.1142/s021881049600018x ◽

1996 ◽

Vol 01 (02) ◽

pp. 103-105

Author(s):

J. Joris Hage ◽

Jaap D.K. Munting

Keyword(s):

Side Effects ◽

Prospective Study ◽

Success Rate ◽

Adult Patients ◽

Methylprednisolone Acetate ◽

Short Term ◽

Local Injections ◽

One Year ◽

A Prospective Study

Thirty-six adult patients with 44 trigger fingers of less than four months' duration entered a prospective study on the efficiency of treatment with local injections of a combination of corticosteroids and lidocaine. From this study it may be concluded that the short-term success rate (93%) of one to three injections of methylprednisolone and lidocaine 2% (Depo-Medrol®) is comparable to that achieved by surgical or percutaneous tenolysis. At one year of follow-up, this success rate still amounted to 86%. In our hands, this therapy is without complications or side effects.

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Total Endoscopic Transcanal Cartilage Myringoplasty: A Prospective Study

International Archives of Otorhinolaryngology ◽

10.1055/s-0039-1691758 ◽

2019 ◽

Vol 23 (04) ◽

pp. e440-e444

Author(s):

Dipesh Shakya ◽

Arun KC ◽

Ajit Nepal ◽

Nirmala Tamang

Keyword(s):

Prospective Study ◽

Chronic Otitis Media ◽

Endoscopic Approach ◽

Closure Rate ◽

Hearing Results ◽

A Prospective Study ◽

Lost To Follow Up ◽

Air Conduction ◽

Hearing Evaluation

Introduction Middle ear surgeries, including myringoplasty, have increasingly utilized endoscopes as an adjunct to or as a replacement for the operative microscope. Objectives The objective of the present study was to evaluate the graft uptake rate and to evaluate the hearing results. Methods This is a prospective study. We have analyzed 139 patients who underwent surgery for chronic otitis media (COM) of the mucosal type. All of the surgeries were performed exclusively under total endoscopic transcanal approach using tragal cartilage as graft, underlay technique. We have evaluated the postoperative graft uptake and performed a hearing evaluation at 6 weeks, at 12 weeks, and at 6 months. Results During the study period, 139 patients were included, out of which 13 were lost to follow-up; therefore, only 126 patients were assessed. All of the cases were performed under total endoscopic approach. As for the surgical outcome at the postoperative otoscopy, 3 cases had initial uptake at 3 months and failed later; therefore, complete closure of the perforation was observed in 97.6% (n = 123) of the patients 6 months after the intervention.Four patients presented with preoperative anacusis; therefore, only 122 patients were included for hearing evaluation. The preoperative air conduction threshold (ACT) and airbone gap (ABG) were 43.34 ± 11.53 and 24.73 ± 7.89, respectively.Postoperatively, the ACT and ABG closure were 28.73 ± 15.75 and 11.91 ± 8.41, respectively. This difference was statistically significant (p < 0.001). Conclusion The endoscopic approach for myringoplasty offers excellent visualization; avoids postaural approach, enables a faster recovery, requires less hospital stay, with excellent graft closure rate and improved functional outcomes.

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Evaluation and comparison of type I tympanoplasty efficacy and histopathological changes to the tympanic membrane in dry and wet ear: a prospective study

The Journal of Laryngology & Otology ◽

10.1017/s0022215115002091 ◽

2015 ◽

Vol 129 (10) ◽

pp. 945-949 ◽

Cited By ~ 15

Author(s):

R Shankar ◽

R S Virk ◽

K Gupta ◽

A K Gupta ◽

A Bal ◽

...

Keyword(s):

Prospective Study ◽

Success Rate ◽

Tympanic Membrane ◽

Histopathological Examination ◽

Chronic Otitis Media ◽

Type I ◽

Significant Difference ◽

Type I Tympanoplasty ◽

One Year ◽

A Prospective Study

AbstractObjective:This study aimed to compare the success rate of type I tympanoplasty in active (wet) and inactive (dry) mucosal chronic otitis media.Methods:A prospective study was performed of 35 patients each with dry ear and wet ear undergoing type I tympanoplasty in the Otolaryngology Department, Postgraduate Institute of Medical Education and Research, India. All patients underwent type I tympanoplasty between January 2010 and June 2011 by the post-auricular approach. Samples of the remnant tympanic membrane were sent for histopathological examination.Results:After a minimum follow up of one year, the success rate was 88.6 per cent for dry ears and 80 per cent for wet ears. Neither the type (p = 0.526) nor the presence (p = 0.324) of discharge influenced the success rate. Histopathological examination of the tympanic membrane margins was performed for 46 patients: of these, 19 showed evidence of vascularity and 27 did not. There was no significant difference in success rate between groups (p = 0.115).Conclusion:The success rate was not influenced by the presence of ear discharge at the time of surgery, and tympanic membrane vascularity did not influence graft uptake.

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Surgery of the Lacrimal System

Surgery of the Eyelid, Lacrimal System, and Orbit ◽

10.1093/oso/9780195340211.003.0021 ◽

2011 ◽

Author(s):

Roger A. Dailey ◽

Mauricio R. Chavez

Keyword(s):

Prospective Study ◽

Success Rate ◽

Nasolacrimal Duct ◽

The Other ◽

Success Rates ◽

Lacrimal Sac ◽

Other Hand ◽

A Prospective Study ◽

External Dcr

Obstruction of the tear outflow system can occur anywhere along its course from the tear lake to the inferior meatus of the nose. Surgical techniques designed to relieve this functional or complete obstruction have been available for a long time. Toti of Italy described the dacryocystorhinostomy (DCR) procedure in 1908 as a treatment modality for obstruction of the nasolacrimal duct. His technique did not make use of mucosal flaps. Dupuy-Dutemps of France, on the other hand, encouraged the use of flaps. He recommended suturing together the nasal mucosal and lacrimal sac flaps. The success rate of the operation improved dramatically. Today the external DCR procedure makes use of modifications of both of these historically described procedures. In recent years, intranasal DCR has enjoyed renewed popularity. This procedure had been performed by Lester Jones and others for years but was dropped because the success rate was 80% at best. Although the use of endoscopic techniques and laser technology has been advocated by some authorities, the success rate (approximately 70%) with relatively short-term follow-up has limited its acceptance. More recently, Javate and associates reported a series of patients undergoing endoscopic DCR with the radiofrequency Ellman unit. Their reported success rate of 90% compared favorably with a 94% success rate in 50 age-matched patients undergoing external DCR with a follow-up of 9 months. This rate also compares favorably to the present authors’ success rate of approximately 95% in uncomplicated cases undergoing external DCR and a similar rate with the endoscopic approach without use of a laser. Therefore, the laser does not appear to offer any significant advantage over more traditional intranasal approaches, and the cost may actually be a financial disincentive to its use. The benefit of mitomycin continues to be debated. You and associates performed a prospective study showing favorable long-term success rates with the use of mitomycin. On the other hand, Liu and associates performed a prospective study that demonstrated no benefit. While the DCR works well for lacrimal sac or nasolacrimal duct obstruction, it does not address obstructions of the puncta and canaliculi.

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A Prospective Comparative Study between Dry and Wet Tympanoplasty

Annals of Otology and Neurotology ◽

10.1055/s-0038-1676951 ◽

2018 ◽

Vol 01 (02) ◽

pp. 083-088 ◽

Cited By ~ 1

Author(s):

Hepsiba Pothala ◽

Sunita Shukla ◽

Wasim Khan ◽

Ravi Ramalingam ◽

Kombupalayam Ramalingam

Keyword(s):

Comparative Study ◽

Otitis Media ◽

Uptake Rate ◽

Chronic Otitis Media ◽

Hearing Improvement ◽

Temporalis Fascia ◽

Suppurative Otitis Media ◽

Significant Difference ◽

Prospective Comparative Study ◽

Contralateral Ear

Abstract Background Tympanoplasty is the well-established procedure for closure of perforations of tympanic membrane. Study Design This study was a prospective comparative study. Objective The objective of this study was to compare the hearing improvement and graft uptake rate between dry and wet tympanoplasty performed on tubotympanic type of chronic suppurative otitis media. Materials and Methods One hundred forty patients with tubotympanic type of chronic otitis media were selected and categorized into dry and wet ears. Tympanoplasty was performed using temporalis fascia by underlay technique in all cases. Postoperatively, graft uptake rate and hearing improvement were analyzed. Results The graft uptake rate was equal in both dry and wet ears, which was statistically insignificant. There was no statistically significant difference in the hearing improvement between the dry ears and wet ears (χ – 2.39, p = 0.122). Conclusion Factors such as age, sex, and status of the contralateral ear and wet ear did not have any impact on the postoperative graft uptake of tympanoplasty. There was no difference in the graft uptake between the dry and wet ears and there was no statistically significant difference between hearing improvement in both and wet ears.

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Comparative study of efficacy of graft placement with and without anterior tagging in type one tympanoplasty for mucosal-type chronic otitis media

The Journal of Laryngology & Otology ◽

10.1017/s0022215111002659 ◽

2011 ◽

Vol 126 (2) ◽

pp. 125-130 ◽

Cited By ~ 14

Author(s):

P Hosamani ◽

L Ananth ◽

S B Medikeri

Keyword(s):

Otitis Media ◽

Chronic Otitis Media ◽

Type I ◽

Graft Material ◽

Hearing Improvement ◽

Hearing Results ◽

Graft Placement ◽

Type I Tympanoplasty ◽

Suitable Technique

AbstractObjectives:To assess the efficacy of anterior tagging of graft material with respect to graft uptake and hearing results, in type I tympanoplasty.Study design:Prospective, randomised, cohort study.Methods:Sixty patients with chronic otitis media of the mucosal type, with pars tensa perforations, were included in the study. Patients were randomly allocated to two groups: group one underwent type one tympanoplasty with anterior tagging, while group two underwent type one tympanoplasty without anterior tagging. Follow up included evaluation of graft uptake and hearing improvement.Results:There were 33 patients in group one and 27 patients in group two. The overall incidence of successful graft uptake was 96.96 per cent in group one and 81.5 per cent in group two. Closure of central and posterior perforations was successful in 100 per cent of both groups. Closure of anterior and subtotal perforations was successful in 95.45 per cent of group one and 54.54 per cent of group two.Conclusion:Type one tympanoplasty with anterior tagging of graft material is a suitable technique for anterior and subtotal perforations.

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Comparative study of type I tympanoplasty using temporalis fascia and tragal cartilage with perichondrium as graft material

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20181873 ◽

2018 ◽

Vol 4 (3) ◽

pp. 789

Author(s):

Arvinder Singh Sood ◽

Pooja Pal ◽

Anshul Singla

Keyword(s):

Tertiary Care ◽

Chronic Otitis Media ◽

Type I ◽

Graft Material ◽

Hearing Improvement ◽

Temporalis Fascia ◽

Tertiary Care Centre ◽

Fascia Graft ◽

Uptake Rates

Background: Temporalis fascia and cartilage are the most commonly used graft materials, though contradictory reports are available in literature as regards their efficacy. The purpose of this study was to compare graft acceptance and auditory outcomes of tympanoplasty using cartilage versus temporalis fascia as graft material.Methods: This prospective study included 40 consecutive cases of chronic otitis media in a tertiary care centre randomised in two groups of 20 patients each to be subjected to tympanoplasty using either tragal cartilage-perichondrium or temporalis fascia graft from January 2011 to November 2012. Graft uptake rates and subjective as well as objective hearing improvement at 2 months and 6 months postoperative follow-up were compared. Results: The mean age of presentation was 34.4 years (range 15-60 years). At 2 months post operatively, the graft uptake was better with tragal cartilage group (95%) than temporalis fascia (90%), while at the end of 6 months graft uptake was better with temporalis fascia (75%) compared to tragal cartilage (70%). Hearing improvement was better for tragal cartilage group compared to the temporalis fascia group at both 2 months and 6 months follow-up. The subjective improvement in hearing at the end of 6 months was also better for tragal cartilage- perichondrium group than the temporalis fascia group.Conclusions: Both temporalis fascia and tragal cartilage–perichondrium are suitable graft materials for tympanoplasty. Graft uptake was superior with temporalis fascia, while hearing improvement was better with tragal cartilage- perichondrium, although the results were not statistically significant.

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