scholarly journals ROLE OF MASTOIDECTOMY IN TYPE 1 TYMPANOPLASTY OF SAFE TYPE CHRONIC SUPPURATIVE OTITIS MEDIA- A PROSPECTIVE STUDY

2016 ◽  
Vol 3 (102) ◽  
pp. 5645-5649
Author(s):  
Sami Ullah ◽  
Faiz S. M ◽  
Mohd Shakeel ◽  
Saurabh Srivastav ◽  
Satveer Singh Jassal ◽  
...  
Author(s):  
Abhay Kumar ◽  
Prabhu Narayan ◽  
Prem Narain ◽  
Jaypal Singh ◽  
Prateek Kumar Porwal ◽  
...  

<p class="abstract"><strong>Background:</strong> Leading cause of deafness in India is chronic suppurative otitis media. Most common cause of TM perforation is chronic suppurative otitis media. With this background this study was to compare hearing results, as well as graft takes for commonly preferred reconstruction techniques of the TM (i.e., temporalis fascia vs. cartilage) in tympanoplasty.</p><p class="abstract"><strong>Methods:</strong> The present study consists of 60 cases of C.S.O.M (TTD) which was divided into two groups with 30 cases in each group. In first group type1 tympanoplasty was done by Temporalis fascia technique. In second group type 1 tympanoplasty done by tragal cartilage with perichondrium technique. History and otoscopic examination along with pure tone audiometry was performed preoperatively. Postoperative hearing results and graft uptake were compared between two groups, all surgeries were performed through the post aural approach.  </p><p class="abstract"><strong>Results:</strong> Graft uptake results are better with tragal cartilage with perichondrium technique. Hearing improved significantly in both groups. Though this was slightly better in TFT, but not significant statistically.</p><p><strong>Conclusions:</strong> Graft uptake rates are better with the tragal cartilage with perichondrium technique in comparison of TFT and hearing results are almost equivalent with both techniques.</p>


1992 ◽  
Vol 101 (10) ◽  
pp. 866-869 ◽  
Author(s):  
Dan M. Fliss ◽  
Naftali Meidan ◽  
Ron Dagan ◽  
Alberto Leiberman

Medical management of chronic suppurative otitis media without cholesteatoma in children was shown recently to be efficacious. We undertook a prospective study in order to determine 1) the organisms associated with the disease and their sensitivity to various antibiotics and 2) their association with clinical variables. Pseudomonas was isolated from 84% of the patients, enteric gram-negative bacilli from 32%, Staphylococcus aureus from 20%, streptococci from 14%, and Hemophilus influenzae from 15%. Pseudomonas aeruginosa was the sole isolate in 48 of the 128 patients (38%). The sensitivity of P aeruginosa (78 isolates) was 100% (of isolates) to mezlocillin and ciprofloxacin, 99% to tobramycin and ceftazidime, 97% to piperacillin, 94% to gentamicin, and 78% to ceftriaxone. The isolated organisms and their sensitivity to antibiotics were not associated with age, sex, duration of otorrhea, or the presence of granulation tissue or polyps. We believe that our data may contribute to the appropriate choice of antibiotics when nonsurgical management of chronic suppurative otitis media without cholesteatoma is considered.


Author(s):  
Kiran A. Deshmukh ◽  
Vinayak Kurle

<p class="abstract"><strong>Background:</strong> Chronic suppurative otitis media attributes to 71.6% of hearing impairment in which most of them only have central perforations without any ossicular erosion or middle ear pathology. There are insufficient explanations to conclude which technique is better for type 1 tympanoplasty. Hence the study was conducted to compare and analyze the endoscopic technique with conventional microscopic technique for performing type 1 tympanoplasty.</p><p class="abstract"><strong>Methods:</strong> This prospective study was done at Basaweshwara teaching and general hospital attached to MR medical college, Kalaburagi from December 2015 to June 2017 after obtaining institutional ethical clearance. Patients were selected according to inclusion and exclusion criteria and randomly posted for surgery by either endoscopic or microscopic technique and results were analyzed.  </p><p class="abstract"><strong>Results:</strong> There were 60 patients in the study between 11-65 years with mean age of 28.85±10.87 years in which were 28 females and 32 were males. All patients were divided into 2 groups in which 30 underwent endoscopic and 30 underwent microscopic type 1 tympanoplasty. In this 46.7% of the patients had left ear conductive hearing loss whereas 31.7% of patients had right ear conductive hearing loss and 21.7% of the patients had bilateral conductive hearing loss which included 22 small perforations, 33 medium size perforations and 5 large perforations of pars tensa.</p><p class="abstract"><strong>Conclusions:</strong> We conclude that endoscope can be a better alternative for microscope in type 1 tympanoplasty as it provides a wide panoramic view, less operating time and hospital stay with negligible scar post operatively.</p>


Author(s):  
Kiran A. Deshmukh ◽  
Vinayak Kurle

<p class="abstract"><strong>Background:</strong> Chronic suppurative otitis media (CSOM) attributes to 71.6% of hearing impairment in which most of them only have central perforation without any ossicular erosion or middle ear pathology. Tympanoplasty has evolved to provide and reconstruct better hearing mechanism, avoid complications as well as recurrence. Traditionally over the decades, tympanoplasty has been done using an operating microscope. Middle ear endoscopy was first introduced by Mer and colleagues in 1967, since then middle ear surgeries which were traditionally done using the microscope can be done using the endoscope also.</p><p class="abstract"><strong>Methods:</strong> This prospective study was conducted at Basaweshwar Teaching and General Hospital, Kalaburagi between March 2016 to November 2017. Endoscopic type 1 tympanoplasty was performed in all the cases using temporalis fascia.</p><p class="abstract"><strong>Results:</strong> There were 30 patients between 15-65 years with average being 29.6 years in which 17 were females and 13 were males. Pre and post-operative PTA at 1, 3 and 6 months were analyzed. The mean duration of surgery was 50.13 mins. The mean duration of hospital stay was 2.23 days. The mean duration of wound healing was 12.23 days. The average pre-operative PTA was 32.47±4.79 dBHL and postoperative PTA at 1, 3 and 6 months was18.3±3.22 dbHL, 16.5±2.2 dbHL and 16.35±2.22 dBHL. The graft uptake at end of 6 months was 100%.</p><p class="abstract"><strong>Conclusions:</strong> We here by conclude that endoscope can be a better alternative for microscope in type 1 tympanoplasty as it provides a wide panoramic view, less operating time and hospital stay with minimal visible scar post operatively.</p>


2018 ◽  
Vol 3 (1) ◽  
pp. 377-380
Author(s):  
Rajeev Kumar Shah ◽  
Karuna Shrestha ◽  
Shrijana Sapkota ◽  
Sandarva Giri

Introduction: Chronic suppurative otitis media (CSOM) is the infection of the middle ear cleft. It is an important cause of preventable hearing loss.Objectives: The primary objective of this study is to compare the surgery outcome in terms of graft uptake described as intact tympanic membrane or residual perforation of tympanic membrane in patients with use of levocetirizine tablet 5 milligram only and levocetirizine tablet 5 milligram with topical fluticasone 100 microgram nasal steroid spray. This study is also aimed to determine the hearing status before and after the surgery and to find out its association with graft intake.Methodology: This prospective cross sectional study was conducted on patients diagnosed with chronic suppurative otitis media with medium to large central perforation of tympanic membrane in Birat Medical College Teaching Hospital during the period from 14 April 2015 to 13 April 2017. All the patients underwent type 1 tympanoplasty with placement of temporalis fascia under general anesthesia. After surgery, two equal groups were created with 40 patients in each group. One group received antibiotics, levocetirizine tablet and another group received antibiotics, levocetirizine tablets along with topical intranasal steroid spray from 1 post operative day till 6 wks. All the patients were followed up on the 5th day, 7th day and 42nd day. On 42nd day, status of tympanic membrane graft, post operative hearing assessment was done and compared between the two groups. Data were entered and analysed using Statistical Package For Social Sciences (SPSS) v21.Result: There were 40 patients who received levocetirizine only starting from the first post operative day and 39 patients received levocetirizine and topical nasal steroid spray. Patients with intact tympanic membrane following surgery were 88.6% and remaining had residual perforation of tympanic membrane. Of the study participants 87.3 % had improvement during post operative hearing assessment. 92.3% of the patients receiving levocetirizine and topical nasal steroid post surgery had intact tympanic membrane on otoscopic examination and there was a significant association with p value of 0.04Conclusion: Combination therapy with topical intranasal steroid spray, antihistaminics and antibiotics is beneficial compared to antibiotics and antihistaminics in type 1 tympanoplasty in terms of graft intake and improvement in hearing. BJHS 2018;3(1)5 : 377-380


2021 ◽  
Vol 8 (7) ◽  
pp. 136-141
Author(s):  
Sumit Sharma ◽  
Chhavi Gupta ◽  
Richa Singh

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.


Author(s):  
Safaa Sahib Naji Sultan ◽  
Malath Azeez Alsaady

  Objective: To evaluate levofloxacin efficiency for treatment of chronic suppurative otitis media in sample of Iraqi patients.Methods: This is a prospective study which includes 50 patients of different age groups diagnosed with CSOM. Aural toilet and otosporin ear drop performed in clinic, then levofloxacin prescribed as single oral tablet daily for 4-6 weeks. Patients were examined every 2 weeks for 8 weeks and then once by month for 6 months to evaluate the efficiency of treatment.Results: Forty patients (80%) showed complete dryness and healing. Discharge decreased upon the visits with more dryness observed after 4 weeks of treatment. Signs of healing and tympanic perforation closure apparently occur about 1 month from the initial treatment in 32 patients (80% of successful treatment). Culture sensitivity tests results were Pseudomonas aeruginosa and Klebsiella species in discharge materials.Conclusion: Levofloxacin is a safe and effective drug for the treatment of CSOM and promising treatment for CSOM in combination with aural toilet. The main species of microorganism detected were P. aeruginosa and Klebsiella.


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