Clinical Treatment and Analysis of 58 Cases of Chronic Suppurative Otitis Media

Hearing Improvement ◽

Hearing Ability ◽

Open Treatment

Objective: Analyzing cause of disease and clinical performance of clinical patients with chronic suppuratie otitis media, as well as discuss the effective surgical treatment methods and post-operative nursing prevention. Methods: 58 cases of chronic suppurative otitis media patients, clinical data and follow-up results were retrospectively analyzed during March 2008 to July 2011 in our hospital, in order to investigate the treatment effect of the operation. Results: 58 cases (60 ears) patients were indicated the procedure, including 33 ears open vesssed dash forward line, and 17 ears did close type papilloma wildly improved, and 10 ears did for drum sinus and attic area open treatment. After 2 years of follow-up observation, fifty-six ears was survived, with the survival rate of 93.3%, and second perforated eardrums happened in 4 ears, accounted for 6.7%. After eight months, There were 31 ears with hearing improvement of 10‒15 dB (accounting for 51.7%), 22 ears with hearing improvement of 15‒30 dB (accounting for 36.7%), 3 ears with no hearing improvement (accounting for 5.0%), 4 ears with mild hearing loss (accounting for 6.7%); total effective rate of hearing improvement was 88.3%, and hearing ability has improved significantly statistical significance. Conclusion: According to the different patients with the disease choosing appropriate surgical method, it has a great significance to enhance the curative rate, reduce post-operative complications and recrudescent possibility.

Assessment of short term hearing improvement in patients of cartilage interposition ossiculoplasty for lenticular process of incus necrosis in cases of chronic suppurative otitis media: mucosal disease

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20173202 ◽

2017 ◽

Vol 3 (4) ◽

pp. 821

Author(s):

Shashikant K. Mhashal ◽

Neeraj R. Shetty ◽

Amit S. Rathi ◽

Vinod A. Gite

Keyword(s):

Otitis Media ◽

Tympanic Membrane Perforation ◽

Hearing Improvement ◽

Short Term ◽

Mucosal Disease ◽

Membrane Perforation ◽

Prevalent Disease

Background: Chronic suppurative otitis media is a highly prevalent disease in developing countries. Hearing loss associated with this disease is significantly more in cases associated with ossicular necrosis along with tympanic membrane perforation. Methods: We would like to present a study of such cases of mucosal chronic suppurative otitis media associated with lenticular process necrosis treated by cartilage interposition ossiculoplasty. The patients were followed up for a minimum period of 6 months and their pre op and post op hearing was documented and analyzed. Results: An average air bone gap of 39.07 decibels in pre op was reduced to 18.13 decibels in post-operative period and these improvements persisted over 6 months of follow-up. Conclusions: We have hereby concluded that the hearing improvement is comparable to other methods of ossiculoplasty with minimum disruption of natural hearing assembly in lenticular process of incus necrosis.

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

Journal of College of Medical Sciences-Nepal ◽

10.3126/jcmsn.v6i4.6723 ◽

2012 ◽

Vol 6 (4) ◽

pp. 31-35 ◽

Cited By ~ 1

Author(s):

LK Yadav ◽

D Shrestha ◽

J Pradhananga

Keyword(s):

Otitis Media ◽

Medical Sciences ◽

Hearing Improvement ◽

Ear Surgery ◽

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

A clinical study of evaluation of tympanoplasty with mastoidectomy in mucosal chronic otitis media

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20195709 ◽

2019 ◽

Vol 6 (1) ◽

pp. 163

Author(s):

Ritesh Mahajan ◽

Nidhi Abraham ◽

Nagaraj T. M.

Keyword(s):

Otitis Media ◽

Disease Process ◽

Chronic Otitis Media ◽

Medical College ◽

Cortical Mastoidectomy ◽

A Prospective Study

Background: Chronic suppurative otitis media (CSOM) is one of the most common ear diseases in developing countries with a varying incidence of 3% to 57%. It the disease process is further divided into mucosal type and squamosal type depending on clinical presentation. The mainstay of therapy in CSOM remains surgery which aims at eradication of disease and restoring the hearing mechanism. The main objective of our study was to evaluate the changes and impact of tympanoplasty with mastoidectomy as a surgical treatment modality in mucosal type of CSOM.Methods: A prospective study was conducted in Rajarajeshwari Medical College and Hospital between November 2015 and June 2017, involving 50 patients with mucosal type of chronic otitis media. These patients, after complete clinical examination and hearing analysis, underwent tympanoplasty with cortical mastoidectomy. Follow-up of the patients was done at one month and three months after the surgery where the parameters recorded preoperatively were assessed. Results: The graft uptake three months after the surgery was 94%. Patients reported a subjective improvement in symptoms of ear discharge, decreased hearing, earache and tinnitus to 94%, 70%, 86% and 78% respectively. There was hearing improvement in ears that had discharge preoperatively and those ears that did not.Conclusions: Chronic suppurative otitis media is a very common problem and it can lead to recurrent ear discharge and hearing problems. Timely intervention is necessary as early diagnosis results in good surgical outcomes and can make an impact on patient’s quality of life.

Follow up System in Middle Ear Surgery for Chronic Suppurative Otitis Media

Hearing Impairment ◽

10.1007/978-4-431-68397-1_76 ◽

2004 ◽

pp. 387-389

Author(s):

Helmi Abdullah

Keyword(s):

Otitis Media ◽

Middle Ear ◽

Middle Ear Surgery ◽

Ear Surgery ◽

Suppurative Otitis Media

Interferon-gamma in suppurative otitis media: significance of otorrhoea type and disease outcome

The Journal of Laryngology & Otology ◽

10.1017/s0022215109990600 ◽

2009 ◽

Vol 123 (10) ◽

pp. 1103-1107 ◽

Cited By ~ 1

Author(s):

A O Lasisi ◽

O Olayemi ◽

O G Arinola ◽

S A Omilabu

Keyword(s):

Standard Deviation ◽

Otitis Media ◽

Middle Ear ◽

Interferon Γ ◽

Enzyme Linked Immunosorbent Assay ◽

The Mean ◽

Prospective Longitudinal

AbstractBackground:Interferon-γ has been reported to have an immunoregulatory role in otitis media with effusion. However, such a role remains to be determined in acute suppurative otitis media.Aim:To determine the levels of interferon-γ in middle-ear secretion in children with acute suppurative otitis media, and to determine the significance of interferon-γ to the nature of otorrhoea and the outcome of otitis media.Settings and design:Prospective, longitudinal follow up of patients selected from community and tertiary health centres.Methods:We selected children with acute suppurative otitis media, diagnosed as otorrhoea of less than three months' duration. Middle-ear secretions were collected by pipetting and stored at −80°C. Interferon-γ was assayed using enzyme-linked immunosorbent assay. The patients were treated and followed up for nine to 12 months, to separate those with resolved acute suppurative otitis media from those with chronic suppurative otitis media.Result:The study initially included 358 cases of acute suppurative otitis media. Nine-month follow up was achieved in 304 patients (85 per cent). Of these patients, acute suppurative otitis media resolved in 187 (61 per cent), while chronic suppurative otitis media was evident in 117 (39 per cent). The children with completed follow up comprised 173 boys and 131 girls, aged between four months and nine years (mean age 6.6 years; standard deviation 1.32). These children had purulent otorrhoea in 171 cases (56 per cent) and mucoid otorrhoea in 133 cases (44 per cent). The children's middle-ear secretion interferon-γ concentrations ranged from 12 to 126 pg/ml. The mean middle-ear secretion interferon-γ concentration was 27.2 pg/ml (standard deviation 8.8) in patients whose acute suppurative otitis media resolved, and 73.1 pg/ml (standard deviation 9.5) in those progressing to chronic suppurative otitis media. In children with purulent otitis media, the mean middle-ear secretion interferon-γ concentration was 43.5 pg/ml (standard deviation 15.6); in those with mucoid otitis media, it was 74.3 pg/ml (standard deviation 19.1). Univariate analysis revealed significant differences in middle-ear secretion interferon-γ concentration, comparing resolved acute suppurative otitis media and chronic suppurative otitis media cases (p = 0.00), and comparing purulent and mucoid otitis media cases (p = 0.00). Pearson correlation testing revealed significant inverse correlation between interferon-γ concentration and middle-ear secretion immunoglobulin G concentration (p = 0.01), immunoglobulin E concentration (p = 0.03) and immunoglobulin A concentration (p = 0.00).Conclusion:A high concentration of interferon-γ in middle-ear secretions promotes chronicity of suppurative otitis media. Further research in this area may lead to the development of agents which assist the control of suppurative otitis media chronicity.

Medical treatment of chronic suppurative otitis media without cholesteatoma in children — a two-year follow-up

International Journal of Pediatric Otorhinolaryngology ◽

10.1016/0165-5876(92)90063-u ◽

1992 ◽

Vol 24 (1) ◽

pp. 25-33 ◽

Cited By ~ 9

Author(s):

Alberto Leiberman ◽

Dan M. Fliss ◽

Ron Dagan

Keyword(s):

Medical Treatment ◽

Otitis Media ◽

Suppurative Otitis Media

Long-term follow-up of chronic suppurative otitis media in a high-risk children cohort

International Journal of Pediatric Otorhinolaryngology ◽

10.1016/j.ijporl.2011.04.017 ◽

2011 ◽

Vol 75 (7) ◽

pp. 948-954 ◽

Cited By ~ 25

Author(s):

Ramon Gordon Jensen ◽

Preben Homøe ◽

Mikael Andersson ◽

Anders Koch

Keyword(s):

High Risk ◽

Otitis Media ◽

Long Term Follow Up ◽

High Risk Children

A comparative study of superiorly based circumferential tympanomeatal flap tympanoplasty with anteriorly anchoring flap tympanoplasty in large, subtotal, and anterior tympanic membrane central perforations in chronic suppurative otitis media of mucosal type

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20180703 ◽

2018 ◽

Vol 4 (2) ◽

pp. 432

Author(s):

Amitkumar Rathi ◽

Vinod Gite ◽

Sameer Bhargava ◽

Neeraj Shetty

Keyword(s):

Comparative Study ◽

Tympanic Membrane ◽

Otitis Media ◽

Statistical Difference ◽

Age Group ◽

Hearing Improvement ◽

Gap Closure ◽

The Mean

Background: The main objective of the study was to assess and compare the graft uptake, hearing improvement, complications in large, subtotal, and anterior moderate perforations by each technique viz; superiorly based circumferential tympanomeatal flap tympanoplasty (STT)/full cuff and anterior anchoring flap tympanoplasty (AAT)/anterior tucking. Methods: In our study of 30 cases age group in the range of 10 years to 60 years. The mean air bone gap for the 8 patients with anterior moderate perforation was 31.75 db, for 17 patients with large central perforations was 38.75 db and for 5 patients with subtotal perforations was 41.4 db. Results: Mean air bone gap closure after 3 months of surgery in the STT group was 21.4 db while that after 6months of the surgery for the same group was 22.06 db. Mean air bone gap closure after 3 months of surgery in the AAT group was 18.2 db while that after 6months of the surgery for the same group was 18.73 db. Conclusions: Comparing the air bone gap closure in patients who underwent surgery by AAT and STT technique we found that there is no statistical difference. Both techniques (viz: superiorly based circumferential tympanomeatal flap tympanoplasty and anteriorly anchoring flap tympanoplasty) can be used for the repair of large, subtotal, and anterior tympanic membrane central perforations in chronic suppurative otitis media of mucosal type.

Chronic Suppurative Otitis Media Atticoantral- Type Undergone Canal Wall Down Mastoidectomy in a Peripheral Government Hospital of Nepal

Journal of Nepal Medical Association ◽

10.31729/jnma.2433 ◽

2013 ◽

Vol 52 (192) ◽

Author(s):

Dhundi Raj Paudel

Keyword(s):

Otitis Media ◽

Canal Wall ◽

Hearing Ability ◽

Peripheral Hospital ◽

Operative Evaluation ◽

Canal Wall Down ◽

Canal Wall Down Mastoidectomy ◽

Operative Assessment

Introduction: Chronic suppurative otitis media is a severe type of chronic ear infection which is quite common in all geographical situations of Nepal. The mainstay of treatment of this disease is surgery, preferably of canal down method. The objective of the study was to identify the common presentation(s) and the clinical and operative finding(s) in patients with chronic suppurative otitis media attico-antral type and evaluation of efficacy of canal-wall down mastoidectomy in the achievement of dry ear and change in hearing in a setting of a peripheral hospital of Nepal in terms of subjectivity. Per-operative evaluation of mastoid cavities in terms of types of pathologies and post- operative assessment of ears in terms of achieving a dryness and change in hearing ability was carried out in the ENT Department, Bharatpur Hospital , Chitwan, Nepal. Study was done from January 2005 to December 2010. Methods: Seventy three patients with chronic suppurative otitis media atticoantral- type were evaluated preoperatively in terms of gross pathologies. Postoperatively, patients were subjectively evaluated twice in six months in reference to persistent ear discharge and change in hearing ability. Results: By six months of surgery, 75% of the patients had no discharge. Fifty two patients did not experience any change in hearing ability. Only 16% experienced betterment in hearing while 19% had diminution in hearing. Conclusions: Canal wall down mastoidectomies are very effective in controlling otorrhoea and complications related to chronic suppurative otitis media attico-antral type. Keywords: Chronic suppurative otitis media attico-antral (CSOM-AA) type; CWD masoidectomy; CWU mastoidectomy; ear cavity.

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

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20180717 ◽

2018 ◽

Vol 4 (2) ◽

pp. 537 ◽

Cited By ~ 1

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 ◽

Hearing Improvement ◽

Significant Difference

Background: 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.Methods: 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. Results: 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). There was a statistically significant difference in pure tone average hearing loss between intact ossicle group (32.87±9.77 dBHL) 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.Conclusions: 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.