scholarly journals A retrospective study on middle ear risk indices in analysing the post-operative outcome following tympanoplasty

2021 ◽  
Vol 7 (9) ◽  
pp. 1468
Author(s):  
Risvana P. P. ◽  
Mubeena K.
Keyword(s):  
Retrospective Study ◽  
Otitis Media ◽  
Middle Ear ◽  
Risk Index ◽  
Chronic Otitis Media ◽  
Favourable Outcome ◽  
Middle Ear Mucosa ◽  
Gap Closure ◽  
Risk Indices ◽  
Outcome Of Surgery

<p class="abstract"><strong>Background:</strong> Chronic otitis media is a highly prevalent disease of middle ear. As tympanoplasty plays an important role in management of otitis media it is important to predict the outcome of surgery and give proper counselling to the patient. The objective of this study was to evaluate the effectiveness of Middle ear risk index (MERI) in determining postoperative graft uptake and postoperative air bone gap closure following tympanoplasty.</p><p class="abstract"><strong>Methods:</strong> This was a retrospective study conducted to find the correlation between MERI and the result of tympanoplasty outcome and post-operative hearing gain. Ninety-six subjects who underwent tympanoplasty for chronic otitis media were included in the study. MERI score was calculated and was compared with postoperative graft uptake and audiogram.  </p><p class="abstract"><strong>Results:</strong> In this study there was no statistical difference in graft uptake between the MERI categories. There was statistically significant decrease in postoperative air bone gap closure in both mild and moderate categories. Other prognostic factors associated with a favourable outcome were healthy middle ear mucosa and absence of smoking.</p><p class="abstract"><strong>Conclusions:</strong> MERI did not have a direct impact on the outcome of surgery in terms of graft uptake and hearing results. However certain factors like Belluci’s criteria and smoking had an impact on the outcome. Hence MERI can be used for pre-operative counselling of the patients.</p>

scholarly journals Prediction of hearing outcomes in chronic otitis media patients underwent tympanoplasty using ossiculoplasty outcome parameter staging or middle ear risk indices

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0252812
Author(s):  
Da Jung Jung ◽  
Hyun Ju Lee ◽  
Ji Song Hong ◽  
Dong Gyu Kim ◽  
Jae Yeon Mun ◽  
...  
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Risk Group ◽  
Risk Index ◽  
Chronic Otitis Media ◽  
Outcome Parameter ◽  
Korean Society ◽  
Risk Indices ◽  
The Mean ◽  
Hearing Outcomes

Purpose Ossiculoplasty outcome parameter staging (OOPS) and middle ear risk index (MERI) are the most commonly used indices for predicting prognosis of patients with chronic otitis media (COM). This study aimed to verify the efficiency of OOPS and MERI scores in predicting outcomes of patients with COM who underwent tympanoplasty. Methods We retrospectively reviewed the data of patients who underwent tympanoplasty (n = 526). OOPS, and MERI scores were collected. Hearing data were measured 1 day preoperatively, and 3 and 12 months postoperatively. Operation success was defined according to the Korean Society of Otology guidelines. Results For calculation of success, the ROC values of MERI were 0.551 at 12 months. ROC values of OOPS were 0.637 at 12 months. There were no significant differences in hearing variables among the three groups according to MERI. There were significantly favorable outcomes in hearing variables in the low-risk group in OOPS. The mean OOPS score was greater in patients with success than those with non-success. Otorrhea, ossicle status, and status of mucosa as variables in both indices were associated with success. The type of mastoidectomy as a variable in OOPS alone was associated with success. Absence of hypertension, presence of ossiculoplasty, and use of incus as ossiculoplasty material were associated with poor success rate. Conclusion Compared with MERI, the OOPS index was more closely associated with the hearing outcomes, which may be due to the extent of inflammation in the OOPS index.

S224 – Efficacy of Long Silastic Sheet in COM Surgery

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P150-P150
Author(s):  
Hyong-Ho Cho ◽  
Hyun-Seok Choi ◽  
Chul-Ho Jang ◽  
Yong-Bum Cho
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Valsalva Maneuver ◽  
Chronic Otitis Media ◽  
Mastoid Cavity ◽  
Middle Ear Mucosa ◽  
Hearing Result ◽  
Staged Operation ◽  
Canal Wall Up

Objectives To determine the effect of long silastic sheet for middle ear aeration in chronic otitis media surgery. Methods Between January 2003 and May 2007, 46 patients underwent planned staged canal wall up tympanomastoidetomy, because possibility of residual cholesteatoma and severe swelling middle ear mucosa, especially around the stapes. Long silastic sheet was inserted from mastoid cavity to middle ear via facial recess during operation procedure. To determine the effect of long silastic sheet for recovery of mastoid aeration, various factors such as computed tomography grading, Valsalva maneuver grading for Eustachian function, and hearing result were compared. Results During the average follow-up of 31 months, there was 1 recurred chronic otitis media which was revealed tuberculosis otitis media. Intact tympanic membrane was obtained in 45(97.8%) of 46 patients. In CT grading, middle ear aeration was increased significantly (p<0.05). Air-Bone gap was significantly decreased after staged operation, preoperative average ABG was 29.7dB and last average ABG was 21.0dB (p <0.05). But Eustachian function using Valsalva manerver was not significantly changed (p >0.05). Conclusions Long silastic sheet insertion from mastoid to middle ear is statistically effective for amelioration of middle ear and mastoid aeration after the first-stage operation.

scholarly journals Direct Detection of Bacterial Biofilms on the Middle-Ear Mucosa of Children With Chronic Otitis Media

JAMA ◽  
2006 ◽  
Vol 296 (2) ◽  
pp. 202 ◽  
Author(s):  
Luanne Hall-Stoodley ◽  
Fen Ze Hu ◽  
Armin Gieseke ◽  
Laura Nistico ◽  
Duc Nguyen ◽  
...  
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Direct Detection ◽  
Chronic Otitis Media ◽  
Bacterial Biofilms ◽  
Middle Ear Mucosa

scholarly journals High Human Papillomavirus DNA loads in Inflammatory Middle Ear Diseases

Pathogens ◽  
2020 ◽  
Vol 9 (3) ◽  
pp. 224 ◽  
Author(s):  
Nicola Malagutti ◽  
John Charles Rotondo ◽  
Luca Cerritelli ◽  
Claudio Melchiorri ◽  
Monica De Mattei ◽  
...  
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Dna Sequences ◽  
Direct Sequencing ◽  
Chronic Otitis Media ◽  
Human Papillomaviruses ◽  
Middle Ear Mucosa ◽  
Suppurative Otitis Media ◽  
Ear Diseases ◽  
Hpv Dna

Background. Previous studies reported human papillomaviruses (HPVs) in middle ear tumors, whereas these viruses have been poorly investigated in chronic inflammatory middle ear diseases. We investigated HPVs in non-tumor middle ear diseases, including chronic otitis media (COM). Methods. COM specimens (n = 52), including chronic suppurative otitis media (CSOM) (n =38) and cholesteatoma (COMC) (n = 14), as well as normal middle ear (NME) specimens (n = 56) were analyzed. HPV sequences and DNA loads were analyzed by quantitative-PCR. HPV genotyping was performed by direct sequencing. Results. HPV DNA was detected in 23% (12/52) of COM and in 30.4% (17/56) of NME (p > 0.05). Specifically, HPV DNA sequences were found in 26.3% (10/38) of CSOM and in 14.3% (2/14) of COMC (p > 0.05). Interestingly, the HPV DNA load was higher in COMC (mean 7.47 copy/cell) than in CSOM (mean 1.02 copy/cell) and NME (mean 1.18 copy/cell) (P = 0.03 and P = 0.017 versus CSOM and NME, respectively). HPV16 and HPV18 were the main genotypes detected in COMC, CSOM and NME. Conclusions. These data suggest that HPV may infect the middle ear mucosa, whereas HPV-positive COMCs are associated with higher viral DNA loads as compared to NME.

scholarly journals Investigation of the Presence of Biofilms in Chronic Suppurative Otitis Media, Nonsuppurative Otitis Media, and Chronic Otitis Media with Cholesteatoma by Scanning Electron Microscopy

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Ercan Kaya ◽  
Ilknur Dag ◽  
Armagan Incesulu ◽  
Melek Kezban Gurbuz ◽  
Mustafa Acar ◽  
...  
Keyword(s):  
Electron Microscopy ◽  
Scanning Electron Microscopy ◽  
Otitis Media ◽  
Middle Ear ◽  
Chronic Otitis Media ◽  
Chronic Suppurative Otitis Media ◽  
Middle Ear Mucosa ◽  
Suppurative Otitis Media ◽  
Tissue Samples ◽  
Scanning Electron

Objective. Biofilms have been shown to play a major role in the pathogenesis of otolaryngologic infections. However, very limited studies have been undertaken to demonstrate the presence of biofilms in tissues from patients with chronic otitis media (COM) with or without cholesteatoma. Our objective is to study the presence of biofilms in humans with chronic suppurative and nonsuppurative otitis media and cholesteatoma.Study Design. In all, 102 tissue specimens (middle ear, mastoid tissue, and ossicle samples) were collected during surgery from 34 patients.Methods. The samples were processed for the investigation of biofilms by scanning electron microscopy (SEM).Results. Our research supports the hypothesis in which biofilms are involved in chronic suppurative otitis media, cholesteatoma, and, to a lesser degree, chronic nonsuppurative otitis media. There were higher rates in hypertrophic and granulated tissue samples than in normal mucosa. In addition, the presence of biofilms was significantly higher in the middle ear mucosa compared with the mastoid and ossicle samples.Conclusion. In the clinic, the careful use of topical or systemic antimicrobials is essential, and, during surgery, hypertrophic tissue must be carefully removed from normal tissue.

Role of Ige-Mediated Hypersensitivity in Otitis Media with Effusion: Pathophysiologic Considerations

1994 ◽  
Vol 103 (5_suppl) ◽  
pp. 15-19 ◽  
Author(s):  
Joel M. Bernstein ◽  
William J. Doyle
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media ◽  
Accessory Cell ◽  
Middle Ear Mucosa ◽  
Mucus Production ◽  
Mediators Of Inflammation ◽  
Ige Mediated

A pathophysiologic model of otitis media with effusion secondary to IgE-mediated hypersensitivity is described. Specific mediators of inflammation are released by mucosal mast cells in the nasal mucosa following the interaction of antigen and specific IgE antibody. These mediators increase vascular permeability, mucosal blood flow, and, most important, mucus production. Furthermore, accessory cell types are recruited by colony-stimulating factors that in turn provide an autocrine-positive feedback for the influx of further inflammatory cells. The eustachian tube is then effectively obstructed by both intrinsic venous engorgement and extrinsic mucus plugs, isolating the middle ear space from the ambient environment The net result is the increased exchange of nitrogen into the middle ear mucosa from the middle ear cavity. This causes the development of a significant middle ear underpressure that disrupts tight junctions and allows for transudation of fluids into the middle ear space. The prolonged obstruction of the eustachian tube with mucus results in middle ear inflammation, mucosal metaplasia, and increased glandular activities, all of which are hallmarks of chronic otitis media with effusion.

scholarly journals Assessment of middle ear risk index in predicting the outcome of treatment of CSOM

2020 ◽  
Vol 6 (11) ◽  
pp. 2075
Author(s):  
Anil S. Harugop ◽  
Somashekhar Abhilasha ◽  
Pratibha S. Desai
Keyword(s):  
Surgical Treatment ◽  
Success Rate ◽  
Middle Ear ◽  
Risk Index ◽  
Prognostic Significance ◽  
Favourable Outcome ◽  
Suppurative Otitis Media ◽  
History Of ◽  
The Cost ◽  
Outcome Of Surgery

<p class="abstract"><strong>Background: </strong>Chronic suppurative otitis media (CSOM) accounts for highly prevalent and serious health problems especially in developing countries. Even though there are good numbers of studies demonstrating the success rate of the procedures to treat CSOM, there is lack of uniformity in assessing the predictors for the outcome of the same. If we can predict the outcome of the surgical procedure depending upon the pathologic condition of the middle ear, the cost effectiveness of the surgery can be improved, and this will also improve the patient’s compliance. The objective of this study is to evaluate a group of patients who underwent surgical treatment for chronic CSOM with reference to the prognostic significance of Middle ear risk index (MERI).</p><p class="abstract"><strong>Methods:</strong> It is a retrospective observational study of patients who underwent surgical treatment for CSOM from the year 2008 to 2020.</p><p class="abstract"><strong>Results: </strong>Out of 1010 surgeries done, total of 287 cases were included in study. In our study the success rate in mild risk index was 76.9%, moderate was 62.2% and only 18% in severe risk index.</p><p class="abstract"><strong>Conclusion: </strong>The outcome of surgery in the patients who undergo surgical treatment for CSOM can be predicted well using MERI. Presence of cholesteatoma and granulation tissue reduces the favourable outcome of surgery justifying the numerical value given in the score. However, presence of ear discharge and history of smoking doesn’t alter the outcome of surgery as long as complete clearance of disease is done.</p>

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