Outcome of Type 1 Tympanoplasty with and without the use of Topical Nasal Steroid: A Comparative Study from Eastern Nepal

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

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Comparative study between result of temporalis muscle fascia and tragal cartilage perichondrium as a graft material in type 1 tympanoplasty

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20180726 ◽

2018 ◽

Vol 4 (2) ◽

pp. 565

Author(s):

Abhay Kumar ◽

Prabhu Narayan ◽

Prem Narain ◽

Jaypal Singh ◽

Prateek Kumar Porwal ◽

...

Keyword(s):

Otitis Media ◽

Pure Tone Audiometry ◽

Chronic Suppurative Otitis Media ◽

Graft Material ◽

Temporalis Fascia ◽

Suppurative Otitis Media ◽

Hearing Results ◽

Group Type ◽

Type 1 Tympanoplasty

Background: 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.Methods: 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. Results: 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.Conclusions: 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.

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

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2016/1167 ◽

2016 ◽

Vol 3 (102) ◽

pp. 5645-5649

Author(s):

Sami Ullah ◽

Faiz S. M ◽

Mohd Shakeel ◽

Saurabh Srivastav ◽

Satveer Singh Jassal ◽

...

Keyword(s):

Prospective Study ◽

Otitis Media ◽

Chronic Suppurative Otitis Media ◽

Suppurative Otitis Media ◽

Type 1 Tympanoplasty ◽

A Prospective Study

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Endoscopic versus microscopic type 1 tympanoplasty in chronic suppurative otitis media- tubotympanic type

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20201289 ◽

2020 ◽

Vol 6 (4) ◽

pp. 720 ◽

Cited By ~ 1

Author(s):

Kiran A. Deshmukh ◽

Vinayak Kurle

Keyword(s):

Hearing Loss ◽

Otitis Media ◽

Conductive Hearing Loss ◽

Chronic Suppurative Otitis Media ◽

Medium Size ◽

Microscopic Technique ◽

Suppurative Otitis Media ◽

Type 1 Tympanoplasty ◽

Conductive Hearing

Background: 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.Methods: 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. Results: 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.Conclusions: 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.

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A study on endoscopic type 1 tympanoplasty in tubotympanic chronic suppurative otitis media

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20194930 ◽

2019 ◽

Vol 5 (6) ◽

pp. 1580

Author(s):

Kiran A. Deshmukh ◽

Vinayak Kurle

Keyword(s):

Hospital Stay ◽

Otitis Media ◽

Middle Ear ◽

Operating Time ◽

Chronic Suppurative Otitis Media ◽

Suppurative Otitis Media ◽

Type 1 Tympanoplasty ◽

Duration Of Surgery ◽

The Mean

Background: 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.Methods: 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.Results: 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%.Conclusions: 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.

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Role of Cortical Mastoidectomy in the Management of Mucosal Chronic Suppurative Otitis Media

International Journal of Research and Review ◽

10.52403/ijrr.20210718 ◽

2021 ◽

Vol 8 (7) ◽

pp. 136-141

Author(s):

Sumit Sharma ◽

Chhavi Gupta ◽

Richa Singh

Keyword(s):

Otitis Media ◽

Chronic Suppurative Otitis Media ◽

Hearing Improvement ◽

Suppurative Otitis Media ◽

Type 1 Tympanoplasty ◽

Cortical Mastoidectomy ◽

Significant Difference ◽

Group A ◽

Group B

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.

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Interlay technique type 1 tympanoplasty, an alternative for closing large central tympanic membrane perforation

Oto Rhino Laryngologica Indonesiana ◽

10.32637/orli.v50i1.356 ◽

2020 ◽

Vol 50 (1) ◽

pp. 84

Author(s):

Anton Budhi Darmawan

Keyword(s):

Success Rate ◽

Tympanic Membrane ◽

Otitis Media ◽

Tympanic Membrane Perforation ◽

Google Scholar ◽

High Success Rate ◽

Suppurative Otitis Media ◽

Type 1 Tympanoplasty ◽

Membrane Perforation

Background: Type 1 tympanoplasty or myringoplasty is the most frequently performed procedure in the field of otology. Type 1 tympanoplasty is a surgical procedure to repair and only involves the restoration of the perforated tympanic membrane. There are three most accepted methods often used universally, namely underlay, overlay, and interlay. The interlay method is a relatively new method developed in 1992 for closing tympanic membrane perforation. This method has a high success rate of 96%. Objective: To report the success of type 1 tympanoplasty with an interlay method to close large central tympanic membrane perforations at Margono Soekarjo District Hospital. Case Report: Reporting 3 cases of chronic tubotympanic suppurative otitis media with large central tympanic membrane perforation which were repaired by type 1 tympanoplasty using interlay method. Clinical Question: Does interlay method type 1 tympanoplasty performed on large central tympanic membrane perforation provide better result compared with other methods of type 1 tympanoplasty? Review Method: Studying the evidence-based literatures on type 1 tympanoplasty interlay methods through Cochrane, Pubmed, and Google Scholar databases. Based on the inclusion and exclusion criteria, three journals were relevant with the reported cases. Result: All three journals stated that interlay method type 1 tympanoplasty had high success rate in terms of closing the tympanic membrane perforation and diminishing air-bone gap. Conclusion: Type 1 Tympanoplasty interlay method could be used as an alternative for the closure of a large central tympanic membrane perforation.Keywords: Chronic Tubotympanic Suppurative Otitis Media, large central tympanic membrane perforation, interlay tympanoplasty ABSTRAK Latar belakang: Timpanoplasti tipe 1 atau miringoplasti merupakan prosedur di bidang otologi yang paling sering dilakukan. Timpanoplasti tipe 1 merupakan metode pembedahan yang bertujuan untuk memperbaiki, dan terbatas hanya di membran timpani. Terdapat tiga metode yang paling diterima dan sering digunakan secara universal, yaitu underlay, overlay, dan interlay. Metode interlay merupakan metode penambalan perforasi membran timpani yang relatif baru, dikembangkan pada tahun 1992. Metode ini mempunyai keberhasilan yang tinggi yaitu mencapai 96%. Tujuan: Melaporkan keberhasilan timpanoplasti tipe 1 dengan metode interlay untuk penutupan perforasi membran timpani sentral besar di RSUD Margono Soekarjo. Laporan kasus: Dilaporkan 3 kasus otitis media supuratif kronik tipe tubotimpani dengan perforasi sentral besar, yang dilakukan timpanoplasti tipe 1 dengan metode interlay. Pertanyaan klinis: Apakah metode interlay timpanoplasti tipe 1 yang dilakukan pada perforasi membran timpani yang besar, dapat memberikan hasil yang lebih baik daripada metode lain timpanoplasti tipe 1? Telaah literatur: Telaah berbasis bukti mengenai timpanoplasti tipe 1 metode interlay melalui database Cochrane, Pubmed, dan Google Scholar. Berdasarkan kriteria inklusi dan ekslusi didapatkan tiga jurnal yang relevan dengan kasus yang dilaporkan. Hasil: Ketiga jurnal tersebut menyatakan bahwa timpanoplasti tipe 1 metode interlay mempunyai angka keberhasilan yang tinggi dalam hal penutupan perforasi membran timpani maupun mengurangi air-bone gap. Kesimpulan: Timpanoplasti tipe 1 metode interlay dapat digunakan sebagai alternatif untuk penutupan perforasi membran timpani sentral yang besar

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Comparative study of type 1 tympanoplasty with and without gel-foam in the middle ear

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20212824 ◽

2021 ◽

Author(s):

G. Abhinav Kiran ◽

Y. Prabhakara Rao ◽

B. Shanthi Priyanka ◽

Supreety .

Keyword(s):

Tympanic Membrane ◽

Middle Ear ◽

Pure Tone Audiometry ◽

Hearing Improvement ◽

Tertiary Referral Hospital ◽

Suppurative Otitis Media ◽

Type 1 Tympanoplasty ◽

Hearing Assessment ◽

One Year

Background: Chronic suppurative otitis media is a widespread disease for which tympanoplasty is frequently undertaken. Gel-foam may cause adhesions and fibrosis and improper packing may physically alter the structure of the tympanic membrane leading to failure of tympanoplasty. The graft can be placed without any middle ear supporting agent wherein the graft is held in position by the surface tension between the novel graft placed and the remnant tympanic membrane. The objectives of this study were to assess the graft uptake and hearing improvement following type 1 tympanoplasty with gel-foam in the middle ear and without gel-foam in the middle ear and to compare and assess results.Methods: This was a randomized control trial done for a period of one year conducted in the department of ENT, at a tertiary referral hospital. 40 patients with dry perforation underwent type 1 tympanoplasty without gel-foam in the middle ear and 40 patients with dry perforation underwent type 1 tympanoplasty with gel-foam in the middle ear. Post-operative follow-up was done to look for graft uptake. Hearing assessment by pure tone audiometry was done 90 days post-operatively. Results: Graft uptake was 82.5% in type 1 tympanoplasty without gel-foam in the middle ear and 85% with gel-foam in the middle ear. Both types of surgeries had significant hearing improvement.Conclusions: Graft uptake is equally good in cases with gel-foam and without gel-foam. Hearing gain is comparable in both groups of patients.

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