scholarly journals A study to evaluate bone and cartilage ossiculoplasty in patients of ossicular disruption due to chronic suppurative otitis media

Author(s):  
Hema Mehra ◽  
Sushma Mahich ◽  
Navneet Mathur ◽  
Mahima Singh

<p class="abstract"><strong>Background:</strong> Ossiculoplasty for ossicualar disruption in patients of chronic otitis media (COM) can be done by using either bone or cartilage. The present study was planned to compare bone and cartilage ossiculoplasty in patients of ossicular disruption due to COM.</p><p class="abstract"><strong>Methods:</strong> The prospective observational study was carried out in patients, who were admitted in the department of otorhinolaryngology of a tertiary care teaching hospital of Rajasthan during two years from November 2017 to November 2019. All patients with ossicular disruption due to COM and conductive hearing loss more than 40db were included in the study. Patients with sensorineural hearing loss were excluded from the study. Pure tone audiometry (PTA) was done before surgery. Hearing improvement was assessed 3, 6 and 12 months after surgery.  </p><p class="abstract"><strong>Results:</strong> In the present study 20 patients underwent bone ossiculoplasty using autologous incus and autologous cartilage was used in 80 patients for ossiculoplasty. Post-operative hearing gain was significantly more in autologous incus patients (22.7±4.2 db) compared to autologous cartilage (19.5±3.4 db) (p=0.002).</p><p><strong>Conclusions:</strong> The present study concluded that post-operative hearing gain was significantly better with autologous incus compared to autologous cartilage although both showed good results in terms of hearing gain. </p>

2021 ◽  
pp. 73-75
Author(s):  
Pasunuti Shravya ◽  
Jyothi Swarup ◽  
Vigeshwar RK

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.


2013 ◽  
Vol 5 (3) ◽  
pp. 133-138
Author(s):  
Sunali Khanna ◽  
R Rangasayee

ABSTRACT Objective Cephalometric assessment of Eustachian tube (ET) parameters and audiological evaluation in Down syndrome (DS) and Chronic Otitis Media (COM) and comparison with controls. The ET length, Total Cranial Base (TCB), Posterior Upper Facial Height (PUFH), Maxillary Depth (MD), s-ba (sella-basion) to Palatal Line (PL) and s-ba to ET length were considered. Materials and methods The study comprised of 75 subjects of both sexes in the age range of 7 to 20 years. Digital lateral cephalometry was performed for DS, COM and controls (n = 25). Pure tone audiometry (PTA) and immittance audiometry (IA) was performed to assess audiological status. Results ET length, PUFH, TCB and MD was found to be significantly reduced in DS and COM. s-ba to PL and s-ba to ET was significantly reduced in DS and COM. The s-ba to PL and s-ba to ET length angle in moderate and severe CHL (Conductive Hearing Loss) was decreased significantly. The s-ba to ET length was significantly decreased in patients with B and C tympanogram. Conclusion Aberration in the dimension of the region of the ET can be considered as a predisposing factor for otitis media and conductive hearing loss in DS. How to cite this article Khanna S, Rangasayee R. Cephalometric and Audiological Assessment of Eustachian Tube in Down Syndrome and Chronic Otitis Media. Int J Otorhinolaryngol Clin 2013;5(3):133-138.


Author(s):  
Rashmi Hansdah ◽  
Kavita Sachdeva

<p><strong>Background: </strong>Chronic suppurative otitis media (CSOM)-unsafe type or atticoantral disease or chronic otitis media-squamosal type is a commonly encountered bone eroding disease of the middle ear whose complications can be potentially fatal.</p><p><strong>Methods:</strong> Retrospective analysis of 80 patients who underwent mastoid exploration in the department of otolaryngology and head and neck surgery, NSCBMCH, Jabalpur between June 2016 and May 2017.</p><p><strong>Results: </strong>Unsafe CSOM is commoner in young males of 16-30-year age group. Foul smelling, scanty, purulent ear discharge was the commonest symptom (97.5%). Attic perforation was the most consistent otoscopic finding (47.5% cases). 15% of our patients had central perforations. Conductive hearing loss was most common (62%) followed by mixed hearing loss (23%) and sensorineural hearing loss (11%). Commonest complication encountered was mastoiditis (27 cases). Mastoidectomy with tympanoplasty was done in almost all cases (97.5%). Attic (96.2%), additus (90%), and antrum (86.2%) were commonly involved by disease process. Incus was found to be most susceptible to erosion (88.5%) while stapes was most resistant (36.25%).</p><p><strong>Conclusions:</strong> Unsafe CSOM presenting late warrant prompt diagnosis and surgical intervention. Unusual presentation like retropharyngeal abscess and trismus should raise suspicion of complicated unsafe CSOM in patients with history of otorrhoea. Canal wall down mastoidectomy with rehabilitation of hearing is the surgery of choice in patients who are unlikely to follow up regularly.</p>


Author(s):  
Santosh Malashetti ◽  
Prabhu Khavasi ◽  
Prasen Reddy ◽  
Karra Bhargavi

<p class="abstract"><strong>Background:</strong> Chronic suppurative otitis media of mucosal variety is one of the most common cause of conductive hearing loss worldwide. Sensorinueral hearing loss is rare but well established complication of chronic suppurative otitis media of squamosal variety. We made an attempt to view the sensorineural hearing loss in mucosal type of chronic otitis media and keeping objectives and aims as follows occurrence of sensorinueral hearing loss in mucosal type of chronic suppurative otitis media; relation of sensorinueral component with age, gender and duration in mucosal type of chronic suppurative otitis media.</p><p class="abstract"><strong>Methods:</strong> A total of 105 cases of mucosal type of CSOM were studied retrospectively for the pattern of hearing impairement on the basis of pure tone audiogram in a Tertiary care hospital. Relation 0f sensorinueral hearing loss with with age, gender and duration in mucosal type of CSOM is compared and tabulated with various studies.  </p><p class="abstract"><strong>Results:</strong> Out of total 105 cases of CSOM of mucosal variety 30 (28.57%) had sensorinueral hearing loss affecting 13 males and 17 females with males to females ratio of 1:1.3.Mean bone conduction thresholds in males at 1 kh, 2 kh and 4 kh is 30.38%, 38.46% and 46.15% respectively and Mean bone conduction thresholds in females at 1 kh, 2 kh and 4 kh is 30.88%, 35% and 44.41% respectively.</p><p class="abstract"><strong>Conclusions:</strong> Significant sensorinueral hearing loss was seen in our study. Age, gender and duration didn’t have any impact on degree of sensorinueral hearing loss.</p>


Author(s):  
Krupal A. Pardhi ◽  
Netra A. Pathak ◽  
Kiran J. Shinde

<p class="abstract"><strong>Background:</strong> Unilateral chronic otitis media (COM) is a condition likely to affect the other side also caused by various etiological factors. If diagnosed and intervened in time, the progression of the disease can be prevented and ear can be protected from various sequelae. Hence, it is important to assess and evaluate the contralateral ear (CLE) completely.</p><p class="abstract"><strong>Methods:</strong> A prospective study of 12 months was conducted in the Otorhinolaryngology department, enrolling 80 patients with unilateral chronic otitis media. The CLE defined as the asymptomatic ear without ear discharge or any other complaints. Otoscopy, pure tone audiometry, tympanometry and X-ray mastoid done on patients. The results were recorded and analysed.  </p><p class="abstract"><strong>Results:</strong> On otoscopic findings 76.36% patients in mucosal and 88% patients in squamosal showed abnormalities in CLE. Pure tone audiometry (PTA) showed 75% patients had hearing loss in CLE 46.25% conductive hearing loss (HL), 11.25% sensorineural HL and 17.5% mixed HL in CLE. In squamosal type of COM 76% patients had hearing impairment as compared to mucosal type 74.54%. In tympanometry findings 58.75% patients had type B curve in CLE. Radiographic finding of CLE showed sclerotic mastoid air cells 32% in squamosal and 9.09% in mucosal type.</p><p class="abstract"><strong>Conclusions:</strong> Approximately 80% patients with unilateral COM have abnormal ear findings in CLE. Squamosal type of unilateral COM had more chances of abnormalities in CLE. In this study results showed that the CLE can also be affected in unilateral COM.</p>


2019 ◽  
Vol 35 (2) ◽  
Author(s):  
Shafaque Mehboob Khan ◽  
Tariq Rafi ◽  
Naveed Ahmed ◽  
Mehjabeen Mehjabeen

Objective: To study the correlation of hearing loss with depression, anxiety and stress in patients suffering from chronic suppurative otitis media in local population of Pakistan. Methods: This is a cross-sectional study conducted from May to September 2018 at tertiary care hospital of Karachi. One hundred and twenty patients of chronic suppurative otitis media were divided into three groups: Group-1 (maintained on ciprofloxacin), Group-2 (maintained on co-amoxicillin) and Group-3 (did not subject to the treatment).The measurement of hearing loss was carried out by pure tone audiometry (PTA) and the depression, anxiety and stress were scored taking depression, anxiety and stress scale (DASS) as tool. To observe the effect of hearing loss on different groups one way ANOVA was applied and Spearman correlation was used to find correlation of depression with hearing loss. Results: There was no significant difference found for hearing loss and severity among the groups treated with ciprofloxacin, co-amoxicillin and not maintained on antibiotic therapy. Positive correlations found between hearing loss and depression, anxiety and stress in patients of the three groups. Conclusion: Depression induced by hearing loss as a result of CSOM in patients need to be monitored during and after treatment and scored so that can be treated by counseling and antidepressant (if required). Information regarding this topic on population of Pakistan will be helpful for health care takers and policy makers to manage mental stress with hearing loss in CSOM. How to cite this:Mehboob S, Rafi SMT, Ahmed N, Mehjabeen. Association of hearing loss with depression, anxiety and stress in patients suffering from Chronic Suppurative Otitis Media. Pak J Med Sci. 2019;35(2):---------. doi: https://doi.org/10.12669/pjms.35.2.152 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2021 ◽  
Vol 15 (8) ◽  
pp. 1817-1819
Author(s):  
Bakht Aziz ◽  
Nasir Riaz ◽  
Ateeq ur rehman ◽  
Mohammad Irshad Malik ◽  
Kashif Iqbal Malik

Background: Permanent perforation in the eardrum with persistent drainage from middle ear for more than six weeks is labelled as chronic suppurative otitis media. The major disability of long standing chronic suppurative otitis media presents as disability in hearing thresholds both in young children and adults. The disease has a fewer prevalence in urban regions and mostly is found in the rural population. Aim: To identifying the Prevalence of hearing loss which is sensorineural in patients having middle ear chronic infection (CSOM). Study design & setting: Cross-sectional survey conducted in the department of ENT, Jinnah Hospital Duration/date of the study: 01st February 2020 to 31STJuly 2020 Methods: A Total number of 180 patients were included as a sample in the study. Keeping the level of confidence to 95% and keeping the margin of error to minimum to 5%. These statistics were generated keeping the frequency level of hearing in these patients to minial of 16%. The sampling technique would be non probability type of sampling with a purpose. Results: The results of the study concluded that patients of both sex ranged between first decade and fifth decade. A total of 180 patients had 114 male gender and 66 female gender patients. Patients having chronic middle ear disease were segregated into CSOM (tubo tympanic) with 137 patients and CSOM (attico antral) with 43 patients. The primary indicator of hearing loss in these patients however showed 23 patients having a hearing loss of sensori neural type and 157 patients did not have any sensori neural hearing loss. Conclusions: This research study draws a conclusion that majority cases of chronic middle ear infection is usually the safe type (Tubo tympanic) while a very fewer of these patients of CSOM would have (Attico antral) or dangerous type of CSOM. The major variable of the research, in the form of hearing loss which was sensori neural in patients presenting with CSOM was (12.8%). This percentage is much lower when compared with conductive hearing loss in CSOM. Keywords: Otitis media of chronic type with suppuration, pure tone audiometry, sensory neural hearing loss


2014 ◽  
Vol 6 (1) ◽  
pp. 1-6
Author(s):  
Sunali Khanna ◽  
R Rangasayee

ABSTRACT Objective Cephalometric assessment of Eustachian tube (ET) parameters and audiological evaluation in Down syndrome (DS) and Chronic Otitis Media (COM) and comparison with controls. The ET length, Total Cranial Base (TCB), Posterior Upper Facial Height (PUFH), Maxillary Depth (MD), s-ba (sella-basion) to Palatal Line (PL) and s-ba to ET length were considered. Materials and methods The study comprised of 75 subjects of both sexes in the age range of 7 to 20 years. Digital lateral cephalometry was performed for DS, COM and controls (n = 25). Pure tone audiometry (PTA) and immittance audiometry (IA) was performed to assess audiological status. Results ET length, PUFH, TCB and MD was found to be significantly reduced in DS and COM. s-ba to PL and s-ba to ET was significantly reduced in DS and COM. The s-ba to PL and s-ba to ET length angle in moderate and severe CHL (Conductive Hearing Loss) was decreased significantly. The s-ba to ET length was significantly decreased in patients with B and C tympanogram. Conclusion Aberration in the dimension of the region of the ET can be considered as a predisposing factor for otitis media and conductive hearing loss in DS.


2015 ◽  
Vol 2 (1) ◽  
pp. 4
Author(s):  
Devashri Uday Patil ◽  
Kiran S. Burse ◽  
Shreeya Kulkarni ◽  
Vandana Sancheti ◽  
Chaitanya Bharadwaj

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.


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