Transcanal Endoscopic Tympanoplasty for Pediatric Patients Under 15 Years of Age With Chronic Otitis Media

Objectives. To evaluate the results of transcanal endoscopic tympanoplasty for pediatric patients with chronic otitis media (COM) and compare them to that of the previously standard microscopic assisted tympanoplasty technique.Methods. The patients were divided into two groups based on the operative method. Group 1 underwent tympanoplasty with a totally endoscopic assisted technique (n=21, 24 ears), and group 2 underwent tympanoplasty with the conventional microscopic technique (n=14, 15 ears). We used a transcanal approach in group 1 and a postauricular approach in group 2. In group 1, there were 15 cases of simple COM and nine cases of adhesive otitis media. In group 2, only 15 cases of simple COM were present. We analyzed the outcomes in terms of the hearing gain according to the surgical method and COM type, operation time, hospital stay after surgery, and graft success rate.Results. Postoperative hearing gain results including air conduction (AC) thresholds and air-bone gap (ABG) were not significantly different between the two groups (P>0.05). In both the groups, significant improvement in the postoperative AC and ABG was observed compared to the preoperative hearing. The hospital stay after surgery was significantly shorter in group 1 than the group 2: 2.1±0.4 days and 4.8±0.9 days (P<0.001), respectively. The intact graft success rate was 91.6% in group 1 and 93% in group 2; the values were not significantly different (P>0.05). There was neither intra- nor postoperative complications.Conclusion. Transcanal endoscopic ear surgery technique is more conservative than microscopic approach and can be performed in pediatric patients under 15 years of age with COM. Moreover, it offers similar surgical results compared to traditional microscopic technique, and a shorter operative time and hospital stay after surgery are the advantages of this technique.

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Paediatric Type I Cartilage Tympanoplasty with or without Concomitant Adeno-tonsillectomy – An Institutional Experience

Bengal Journal of Otolaryngology and Head Neck Surgery ◽

10.47210/bjohns.2020.v28i2.322 ◽

2020 ◽

Vol 28 (2) ◽

Author(s):

Santanu Dutta ◽

Soumya Ghatak ◽

Somnath Saha

Keyword(s):

Otitis Media ◽

Chronic Otitis Media ◽

Type I ◽

Age Group ◽

Hearing Gain ◽

Cartilage Tympanoplasty ◽

Paediatric Age ◽

Type I Tympanoplasty ◽

Group 2 ◽

Group 1

Introduction In the management of COM in paediatric age group, eradication of the septic foci in the tonsil and the adenoids while addressing the dysfunction of Eustachian tube play a key role This study aims to assess the success rate of type I tympanoplasty with cartilage graft in mucosal type of chronic otits media in paediatric age group and finally, whether concomitant adeno-tonsillectomy plays any role in outcome of surgery or curing the disease process. Materials and Methods A prospective clinical study was done over a period of one and half years amongst 59 patients, aged between 5 and 12 years, presenting with chronic otitis media with dry central perforation of ear-drum and pure conductive hearing loss. Patients were divided into two groups. Group 1 (n1= 22) underwent type I cartilage tympanoplasty with adenoidectomy/ tonsillectomy/ both in the same sitting and Group 2 (n2= 37) underwent type I cartilage tympanoplasty without any adeno-tonsillectomy. Results Graft uptake was 86.4% in Group 1 at 6 months post-operative follow up while that in Group 2 was found to be 86.5%. The mean hearing gain in two groups were found to be 15.91±6.54 dB and 17.02±8.96 dB respectively. No significant difference was found between graft uptakes and hearing gains in two groups at the end of the study. Conclusion Type I cartilage shield tympanoplasty, may be considered as an effective management strategy of paediatric chronic otitis media, mucosal disease. Type I tympanoplasty with concomitant adeno-tosillectomy did not prove to be better than type I tympanoplasty alone in terms of anatomic closure of tympanic perforation and hearing gain.

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Which factors affect the success of pediatric PCNL? Single center experience over 20 years

Archivio Italiano di Urologia e Andrologia ◽

10.4081/aiua.2020.4.345 ◽

2020 ◽

Vol 92 (4) ◽

Author(s):

Volkan Izol ◽

Nihat Satar ◽

Yıldırım Bayazit ◽

Fatih Gokalp ◽

Nebil Akdogan ◽

...

Keyword(s):

Blood Transfusion ◽

Blood Loss ◽

Hospital Stay ◽

Percutaneous Nephrolithotomy ◽

Pediatric Patients ◽

Operation Time ◽

Fluoroscopy Time ◽

Postoperative Blood Transfusion ◽

Group 2 ◽

Group 1

Objective: We aimed to investigate the impact of surgeons’ experience on pediatric percutaneous nephrolithotomy (PCNL) outcomes. Materials and methods: Between June 1997 and June 2018, 573 pediatric patients with 654 renal units underwent PCNL for renal stone disease by senior surgeons. Data were divided into two groups, group-1 (n = 267), first ten years period, group-2 (n = 387); second ten years period. Results: Mean ± SD age of patients was 7.6 ± 4.9 (1-17) years. The stone-free rates (SFR) assessed after 4 weeks were 74.9% vs. 83.4% in group-1 vs. group-2, respectively (p = 0.03). The mean operation time, fluoroscopy time, and the number of patients requiring blood transfusion significantly decreased in group 2 (100.4 ± 57.5 vs. 63.63 ± 36.3, 12.1 ± 8.3 vs. 8.3 ± 5.4, and 24.3% vs. 2.9%; p < 0.001, p < 0.001, and p = 0.002 in group-1 versus group-2, respectively). On multivariate analysis, increasing stone size increased operation time (p < 0.001), fluoroscopy time (p < 0.001), intraoperative and postoperative blood transfusion rates (p = 0.006 and p = 0.018, respectively), and hospital stay (p = 0.002) but was not associated with change of glomerular filtration rate (GFR) (p = 0.71). Sheath size also correlated with increased fluoroscopy time (p < 0.001), operation time (p < 0.001), intraoperative blood transfusion (p < 0.001) and hospital stay, but sheath size did not affect postoperative blood transfusion (p = 0.614) or GFR change (p = 0.994). Conclusions: The percutaneous nephrolithotomy (PCNL) is a minimally invasive procedure and is well accepted because of its lower complication rate and high efficiency for pediatric patients. Stone and sheath size are predictive factors for blood loss and hospital stay. During 20 years, our fluoroscopy time, operation time, blood loss, and complication rates decreased, and stone-free rate increased.

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PLATELET COUNT INCREASES IN CHRONIC OTITIS MEDIA PATIENTS WITH BLOCKED EUSTACHIAN TUBE

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i5.244 ◽

2019 ◽

Vol 3 (5) ◽

Author(s):

Okan DIKKER ◽

Cem ALTINDAĞ ◽

Güven YILDIRIM ◽

Tolgar Lütfi KUMRAL

Keyword(s):

Platelet Count ◽

Otitis Media ◽

Eustachian Tube ◽

Chronic Otitis Media ◽

Residual Pressure ◽

Old Patients ◽

Significant Difference ◽

Group 3 ◽

Group 2 ◽

Group 1

Objectives: The aim of the present study was to examine the levels of complete blood count (CBC) parameters (Neutrophil, lymphocyte, platelets, MPV, NLR, and PLR) in patients with both perforated eardrums and dysfunctional eustachian tubes to determine which of these parameters might be reliable biomarkers of chronic otitis media prior to surgery, as inflammation is significant component of middle ear pathology. Materials and methods: In this study, we enrolled 95 patients with 18-65 years old. Patients with chronic otitis media (perforated tympanic membranes) more than three months in duration who have no draining ears, were enrolled in Okmeydani Training & Research Hospital. Patients were divided into three groups: Group 1 is “Open eustachian tube” group in which pressure changes (if evident) during swallowing were recorded on stepladder-type graphs; Group 2 is “Blocked” group, who could not neutralize the negative pressure even by repeated swallowing. Group 3 is “Partially blocked” group in whom some residual pressure persisted even after five swallows. The groups were compared in terms of laboratory tests. Results: There was a statistically significant difference between 3 groups in terms of platelet levels (p>0.05). We found that group 2 / blocked eustachian tube had significantly increased platelet counts values when compared to the group 1 and 3. There was no significant difference among group 1 and group 3. There was no statistically significant difference between the 3 groups in terms of neutrophil, lymphocyte count, MPV, NLR, PLR levels, bone and air hearing thresholds. Conclusion: We found that the platelet count increased in chronic otitis media patients with blocked eustachian tube. This may be a simple and inexpensive biomarker with acustic impedencemeter tests supporting eustachian dysfunction before tympanoplasties. Key Words: Hematological biomarkers; eustachian tube dysfunction; chronic otitis media

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A comparative study of endoscopic cartilage myringoplasty used to treat wet and dry ears with mucosal-type chronic otitis media

The Journal of Laryngology & Otology ◽

10.1017/s0022215120001486 ◽

2020 ◽

Vol 134 (9) ◽

pp. 773-778

Author(s):

Z Lou ◽

X Li

Keyword(s):

Comparative Study ◽

Success Rate ◽

Tympanic Membrane ◽

Otitis Media ◽

Chronic Otitis Media ◽

Success Rates ◽

Hearing Gain ◽

Tympanic Membrane Perforations ◽

The Difference ◽

Graft Success

AbstractObjectiveThe outcomes of dry and wet ears were compared following endoscopic cartilage myringoplasty performed to treat chronic tympanic membrane perforations in patients with mucosal chronic otitis media.MethodsPatients with chronic perforations, and with mucosal chronic otitis media with or without discharge, were recruited; all underwent endoscopic cartilage myringoplasty. The graft success rate and hearing gain were evaluated at six months post-operatively.ResultsThe graft success rates were 85.9 per cent (67 out of 78) in dry ears and 86.2 per cent (25 out of 29) in wet ears; the difference was not significant (p = 0.583). Among the 29 wet ears, the graft success rates were 100 per cent in 11 ears with mucoid discharge and 77.8 per cent in the 18 patients with mucopurulent otorrhoea.ConclusionThe wet or dry status of ears in patients with chronic perforations with mucosal chronic otitis media did not affect graft success rate or hearing gain after endoscopic cartilage myringoplasty. However, ears with mucopurulent discharge were associated with increased failure rates and graft collapse, whereas ears with mucoid discharge were associated with higher graft success rates.

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Simultaneous Bilateral Same-Day Endoscopic Myringoplasty Using Tragal Cartilage From One Ear

Ear Nose & Throat Journal ◽

10.1177/0145561319854065 ◽

2019 ◽

Vol 99 (8) ◽

pp. 522-527 ◽

Cited By ~ 1

Author(s):

Baklaci Deniz ◽

Kuzucu Ihsan ◽

Guler Ismail ◽

Kum Rauf Oguzhan ◽

Ozcan Muge

Keyword(s):

Chronic Otitis Media ◽

Operation Time ◽

Entire Group ◽

Success Rates ◽

Endoscopic Myringoplasty ◽

The Mean ◽

The Difference ◽

Group 2 ◽

Graft Success ◽

Group 1

The aim of this study is to investigate the outcomes of bilateral same-day endoscopic myringoplasty using tragal cartilage from one ear in patients with bilateral chronic otitis media. In this retrospective study, medical records of 62 (84 ears) patients aged between 18 and 65 years who underwent endoscopic myringoplasty at our center between January 2015 and December 2017 were evaluated. Patients were classified into 2 groups according to surgical procedure they received: unilateral myringoplasty (group 1) and bilateral same-day myringoplasty (group 2). The comparisons were made between groups in terms of anatomical graft success and functional outcomes. There were 40 patients in the unilateral group (group 1) and 22 patients in the bilateral same-day group (group 2). The graft success rates were 92.5% and 93.2% for groups 1 and 2, respectively ( P = .904). The mean preoperative air–bone gaps (ABGs) were 21.1 ± 7.1 and 20.5 ± 6.7 dB, respectively, whereas the mean postoperative ABGs were 8.1 ± 2.7 dB and 7.9 ± 3.0 dB, respectively. The difference between pre- and postoperative ABGs for the entire group was statistically significant ( P < .001). Mean hearing gain was 12.5 ± 11.0 dB and 15.6 ± 10.1 dB in groups 1 and 2, respectively, ( P = .183). Postoperative ABG was ≤10 dB in 33 (82.5%) and 36 (81.8%) ears in groups 1 and 2, respectively. The functional success rates were similar in both groups ( P = .582). The average lengths of operation time were 61.6 ± 12.5 minutes and 110.1 ± 25.2 minutes for groups 1 and 2, respectively. Bilateral same-day endoscopic myringoplasty using tragal cartilage from one ear seems to be a safe and satisfactory procedure with a good satisfactory success rate.

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Endoscopic cartilage tympanoplasty in chronic otitis media

The Journal of Laryngology & Otology ◽

10.1017/s002221511500239x ◽

2015 ◽

Vol 129 (11) ◽

pp. 1073-1077 ◽

Cited By ~ 19

Author(s):

A Özgür ◽

E Dursun ◽

Ö Ç Erdivanli ◽

Z Ö Coşkun ◽

S Terzi ◽

...

Keyword(s):

Otitis Media ◽

Chronic Otitis Media ◽

Type I ◽

Success Rates ◽

Hearing Improvement ◽

Endoscopic Techniques ◽

Cartilage Tympanoplasty ◽

Graft Success ◽

Endoscopic Cartilage Tympanoplasty ◽

Endoscopic Tympanoplasty

AbstractObjectives:The use of endoscopic techniques is becoming more widespread in otological and neuro-otological surgery. One such procedure, endoscopic tympanoplasty, is used in chronic otitis media treatment. This study aimed to analyse the results of endoscopic transcanal cartilage tympanoplasty.Methods:Data of tubotympanic chronic otitis media patients who underwent transcanal endoscopic type I cartilage tympanoplasty between June 2012 and May 2013 were analysed. The main outcome measures were graft success and hearing improvement.Results:Graft success rates were 94.3 per cent and 92.5 per cent at post-operative months one and six, respectively. Post-operative air–bone gap values were significantly improved over pre-operative values (p < 0.01).Conclusion:Transcanal endoscopic type I cartilage tympanoplasty is a minimally invasive, effective and reliable surgical treatment option for chronic otitis media.

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Comparative study of graft materials used in myringoplasty

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20191481 ◽

2019 ◽

Vol 5 (3) ◽

pp. 549

Author(s):

Anchal Gupta ◽

Apurab Gupta ◽

Padam Singh Jamwal

Keyword(s):

Comparative Study ◽

Otitis Media ◽

Chronic Otitis Media ◽

Hearing Improvement ◽

Temporalis Fascia ◽

Suppurative Otitis Media ◽

Central Perforation ◽

Fascia Graft ◽

Group 2 ◽

Group 1

Background: Various graft materials are used for myringoplasty in practice. Present study was done to compare the hearing improvement and graft uptake rate in patients with inactive mucosal type chronic otitis media with central perforation undergoing myringoplasty using either of the two graft materials: temporalis fascia and conchal perichondrium.Methods: Patients with tubotympanic type of chronic suppurative otitis media were selected from patients attending the ENT OPD of SMGS Hospital, Government Medical College, Jammu between July 2016 to March 2018. This study included 100 patients out of which 50 were subjected to myringoplasty with temporalis fascia grafting (Group 1) and remaining 50 to conchal perichondrium grafting (Group 2) using underlay technique. The comparative study was done on following parameters-graft uptake and audiological outcome. Results: 82% patients were of age less than 30 years. The overall male: female ratio was 1.3:1. In Group 1, 76% had gain of 15 db while 12% had gain of >15 db. In Group 2, 72% had gain of 15 db and 8% had gain of >15 db. The graft was intact in 84% patients. 12% of Group 1 patients, showed residual perforation whereas it was 20% in Group 2 patients.Conclusions: The study showed that: the temporalis fascia graft is better than conchal perichondrial graft for closure of perforations in inactive mucosal type of chronic otitis media with central perforation because of maximum hearing improvement and minimal failure rate in group receiving temporalis fascia graft.

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Benefit of Tympanoplasty with or without Cortical Mastoidectomy in Active Mucosal Otitis Media – A Comparative Study

Bengal Journal of Otolaryngology and Head Neck Surgery ◽

10.47210/bjohns.2019.v27i1.229 ◽

2019 ◽

Vol 27 (1) ◽

Author(s):

Anushree Raviprakash Bajaj ◽

Shahnaz Sheikh ◽

Samir Joshi ◽

Bhalchandra Paike

Keyword(s):

Otitis Media ◽

Hearing Threshold ◽

Chronic Otitis Media ◽

Research Articles ◽

Hearing Improvement ◽

Post Operative Period ◽

Cortical Mastoidectomy ◽

Significant Difference ◽

Group 2 ◽

Group 1

Introduction: Chronic otitis media (COM) is amongst the most common diseases treated by ENT surgeons in India. It has been advocated in lot of research articles that there is no significant difference in tympanoplasty done in active and inactive COM. The objective was to see if cortical mastoidectomy in cases of active mucosal COM, improves the success rate of tympanoplasty measured as per the following parameters: improvement in the hearing threshold by 15 dB, increased graft uptake and reduction in retraction of tympanic membrane in post operative period. Materials and Methods: This study comprises of 120 patients coming to the ENT OPD from October 2016 to October 2017 with active mucosal COM with central perforation requiring tympanoplasty. These patients were randomly assigned to two groups: Group 1 of 60 subjects in which tympanoplasty without mastoidectomy was done, Group 2 of 60 subjects in which tympanoplasty with mastoidectomy was done. Patients were evaluated after a post operative period of 3 months. Results: The Results were the hearing improvement was 73.33% in group 1 while 83.33% in group 2, graft uptake was 63.33% in group 1 and 80% in group 2, graft retraction was 33.33% and 23.33% in group 1 and group 2 respectively. Conclusion: There was statistically significant difference in results in group with and without mastoidectomy in active mucosal chronic otitis media with respect to graft uptake and improved hearing.

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Efficacy of Probiotic Saccharomyces boulardii as an Adjuvant Therapy in Acute Childhood Diarrhoea

Journal of Nepal Paediatric Society ◽

10.3126/jnps.v36i3.15539 ◽

2017 ◽

Vol 36 (3) ◽

pp. 250-255 ◽

Cited By ~ 5

Author(s):

Dillip Kumar Dash ◽

Mrutunjaya Dash ◽

M.D. Mohanty ◽

Naresh Acharya

Keyword(s):

Hospital Stay ◽

Tertiary Care ◽

Acute Diarrhoea ◽

Oral Rehydration Therapy ◽

Saccharomyces Boulardii ◽

Care Hospital ◽

Oral Rehydration ◽

Group 2 ◽

A Prospective Study ◽

Group 1

Introduction: Administration of S. boulardii in addition to rehydration therapy in diarrhea found to be beneficial in many aspects owing to a variety of causes and importantly it is was not associated with any adverse effects.Material and Methods: We conducted a prospective study of children suffering from acute diarrhoea, at a private tertiary care hospital. Children were divided into 2 groups randomly as per odd(Group 1 ) and even (Group 2) bed allotted in indoor at the time of admission: Group 1 included children on oral rehydration therapy (ORT) + Zinc + Saccharomyces boulardii (Probiotic 5 billion CFU twice daily) and Group 2 comprised of children on ORT+ Zinc. Our objective was to systematically review data on the effect of S. boulardii on acute childhood diarrhoea.Results: Out of a total of 126 children less than 2 years, 2-6 years and 6-14 years were 72 (57.14%), 42(33.33%) and 12(09.52%) respectively. The duration of diarrhoea in Group 1 was 26.31 hours and Group 2 was 47.81 hours (p<0.01). The frequency of diarrhoea showed improvement within 24 and 72 hours in Group 1 and Group 2 respectively (p<0.01).Similarly, the mean duration of hospital stay was 2.68 days in Group 1 and 4.8 days in Group 2.The treatment cost was INR 850 and INR 1650 while social cost was INR 1250 and 2600 in Group 1 and 2 respectively.Conclusion:This study shows that S. boulardii reduced the duration, frequency and hospital stay of diarrhoea thereby reducing the treatment and social costs.J Nepal Paediatr Soc 2016;36(3):250-255

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