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

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

Download Full-text

Correlation of the Puretone Audiometry Findings with Intraoperative Findings in Patients with Chronic Suppurative Otitis Media

MVP Journal of Medical Sciences ◽

10.18311/mvpjms/2015/v2/i1/790 ◽

2015 ◽

Vol 2 (1) ◽

pp. 4

Author(s):

Devashri Uday Patil ◽

Kiran S. Burse ◽

Shreeya Kulkarni ◽

Vandana Sancheti ◽

Chaitanya Bharadwaj

Keyword(s):

Hearing Loss ◽

Otitis Media ◽

Pure Tone ◽

Pure Tone Audiometry ◽

Ossicular Chain ◽

Chronic Suppurative Otitis Media ◽

Suppurative Otitis Media ◽

Number Of Patients ◽

Operative Findings ◽

Air Conduction

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. Aims and Objectives: 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. Materials and Methods: 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. Result: 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. Conclusion: 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.

Download Full-text

Perbedaan sensitivitas tetes telinga antibiotik terhadap Pseudomonas aeruginosa pada otitis media supuratif kronik

Oto Rhino Laryngologica Indonesiana ◽

10.32637/orli.v42i2.22 ◽

2012 ◽

Vol 42 (2) ◽

Author(s):

Anton Budhi Darmawan ◽

Dwi Utami Anjarwati

Keyword(s):

Pseudomonas Aeruginosa ◽

Otitis Media ◽

Chronic Suppurative Otitis Media ◽

Test Results ◽

Sectional Study ◽

Suppurative Otitis Media ◽

Number Of Patients ◽

Significant Difference ◽

Cochran Test ◽

Post Hoc

Background: Chronic suppurative otitis media (CSOM) is one infectious disease of the middle ear, most commonly caused by Pseudomonas aeruginosa. A high number of patients come to the ENT outpatient clinic with active benign type of CSOM. The bacteria Pseudomonas aeruginosa is capable of producing biofilm which protects itself from penetration of antibiotics, and therefore creates resistance towards antibiotics and difficult to eradicate. Objective: The aim of this study was to compare the sensitivity levels of chloramphenicol, polymyxin-neomycin, cyprofloxacin and ofloxacine against Pseudomonas aeruginosa in patients with active benign type CSOM in ENT clinic. Method: The method used was across sectional study on 25 patients, from August 2010 until December 2010. Samples were taken withear swab and then put on sensitivity test to chloramphenicol, polymyxin-neomycin, cyprofloxacin andofloxacine using the diffusion disc method. The analysis used in this study was Cochran test. Results: Results showed a significant difference in sensitivity among chloramphenicol (38,70%), polymyxinneomycin(83,87%),cyprofloxacin(90,32%)andofloxacin(58,06%)withp=0,000(p<0,05).PostHocanalysisusing the Mc Nemar indicated that there were significant differences in sensitivity betweenpolymyxin-neomycin to chloramphenicol with p=0,000 (p<0,05), ciprofloxacin to chloramphenicol andciprofloxacin to ofloxacine with p= 0,002, but there were no significant differences between cyprofloxacinto polymyxin-neomycin with p=0,687, polymyxin-neomycin to ofloxacin p=0.057 and ofloxacin tochloramphenicol p=0,109. There were significant differences in antibiotic ear dropssensitivity to Pseudomonas aeruginosa in patients with active benign type of CSOM. Cyprofloxacin andpolymyxin-neomycin were more sensitive than ofloxacin and chloramphenicol. Keywords: Pseudomonas aeruginosa, active benign type of chronic suppurative otitis media, antibioticear drops. Abstrak : Latar belakang: Otitis media supuratif kronik (OMSK) merupakan penyakit infeksi kronik telinga tengah yang sering dijumpai di klinik THT. Penyebab tersering OMSK adalah bakteri Pseudomonasaeruginosa. Pseudomonas aeruginosa mempunyai kemampuan untuk membentuk biofilm yangmelindunginya dari penetrasi antibiotik sehingga menimbulkan resistensi terhadap antibiotik dan sulituntuk eradikasinya. Tujuan: Untuk mengetahui perbandingan tingkat sensitivitas kloramfenikol,polimiksin-neomisin, ciprofloksasin dan ofloksasin terhadap isolat Pseudomonas aeruginosa padapasien OMSK benigna aktif di klinik THT RSMS. Metode: Metode yang digunakan adalah crosssectional terhadap 29 pasien OMSK di klinik THT RSMS periode bulan Agustus 2010 - Desember2010. Pengambilan sampel dilakukan dengan swab telinga. Uji sensitivitas terhadap kloramfenikol,polimiksin-neomisin, ciprofloksasin dan ofloksasin dilakukan dengan metode cakram secara difusi.Analisis yang digunakan dalam penelitian ini adalah Cochran dan analisis post hoc. Hasil: Didapatkansensitivitas kloramfenikol sebesar 38,70%, polimiksin-neomisin sebesar 83,87%, ciprofloksasin sebesar90,32% dan ofloksasin sebesar 58,06% dengan p=0,01 (P<0,05), yang menunjukkan adanya perbedaansensitivitas yang bermakna antara kloramfenikol, polimiksin-neomisin, ciprofloksasin dan ofloksasinterhadap Pseudomonas aeruginosa. Analisis post hoc menggunakan Mc Nemar menunjukkan bahwaterdapat perbedaan sensitivitas yang bermakna antara tetes telinga polimiksin-neomisin terhadapkloramfenikol, dan ciprofloksasin terhadap kloramfenikol p=0,000 (p<0,05), serta terdapat perbedaanyang bermakna antara tetes telinga ciprofloksasin terhadap ofloksasin, p=0,002, tetapi tidak terdapatperbedaan yang bermakna antara ciprofloksasin terhadap polimiksin-neomisin, p=0,687, polimiksinneomisinterhadap ofloksasin p=0,057, dan kloramfenikol terhadap ofloksasin p=0,109. Kesimpulan:Terdapat perbedaan sensitivitas yang bermakna tetes telinga antibiotik terhadap Pseudomonas aeruginosa pada pasien OMSK benigna aktif. Ciprofloksasin dan polimiksin-neomisin tetes telinga mempunyai sensitivitas yang lebih baik dibanding ofloksasin dan kloramfenikol. Kata kunci: Pseudomonas aeruginosa, otitis media supuratif kronik, tetes telinga antibiotik

Download Full-text

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 ◽

Chronic Suppurative Otitis Media ◽

Middle Ear Surgery ◽

Ear Surgery ◽

Suppurative Otitis Media

Download Full-text

Correlation of Pure Tone Audiogram Results and Hearing Benefit of Tympanoplasty for Chronic Suppurative Otitis Media

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348940010900408 ◽

2000 ◽

Vol 109 (4) ◽

pp. 381-384 ◽

Cited By ~ 6

Author(s):

Anthony Po Wing Yuen ◽

Wai Kuen Ho ◽

Yau Hui ◽

William Ignace Wei ◽

Dennis Kin Kwok Au

Keyword(s):

Otitis Media ◽

Pure Tone ◽

Chronic Suppurative Otitis Media ◽

Suppurative Otitis Media ◽

Pure Tone Audiogram

Download Full-text

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

Advanced Emergency Medicine ◽

10.18686/aem.v1i1.1 ◽

2012 ◽

Vol 1 ◽

pp. 1

Author(s):

Yan Wang

Keyword(s):

Otitis Media ◽

Clinical Performance ◽

Statistical Significance ◽

Effective Rate ◽

Chronic Suppurative Otitis Media ◽

Hearing Improvement ◽

Suppurative Otitis Media ◽

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.

Download Full-text

Study of pathology of ossicles in non-cholesteatomatous chronic suppurative otitis media, its repair and outcome

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20180699 ◽

2018 ◽

Vol 4 (2) ◽

pp. 462

Author(s):

C. R. Vijay Bharath Reddy ◽

M. Santhosh Reddy

Keyword(s):

United States ◽

Hearing Loss ◽

Otitis Media ◽

The United States ◽

Septal Cartilage ◽

Chronic Suppurative Otitis Media ◽

Medical Sciences ◽

Suppurative Otitis Media ◽

Operative Results ◽

Subtotal Perforation

Background: If the ears have perforation of long standing durations, even without cholesteatomas, they remain infected. Three times as many operations were performed in the United States in 1978 for this disease as were performed for cholesteatoma. The objective of the study was to study of pathology of ossicles in non-cholesteatomatous chronic suppurative otitis media, its repair and outcome. Methods: This is a clinical study of patients presented to outpatient, department of Vijayanagar Institute of Medical Sciences, Bellary during the period of November 2004 to November 2005 with non-cholesteatomatous chronic suppurative otitis media. This study is aimed to study the various ossicular abnormalities encountered in non-cholesteatomatous chronic suppurative otitis media and their reconstruction techniques. Results: 12 ears (40%) had central and 18 ears (60%) had subtotal perforation. The average hearing loss in patients with isolated erosion of lenticular process of incus was 50.72±6.95 dB. In our study, autologous incus was used for ossicular reconstruction in 14 (46.67%) patients and homologous septal cartilage in 10 (33.33%) cases. Twenty-nine of the 30 cases underwent myringostapediopexy (type IIIb tympanoplasty) with the ossicular graft as short columella between the tympanic membrane graft and the stapes superstructure. Conclusions: Excellent results were noted only with the autologous incus graft. 28.57% of the total patients with autologous incus graft showed excellent post-operative results. Good results were found for autologous incus, homologous septal cartilage and teflon PORP, with percentage of 28.57, 50 and 25% respectively.

Download Full-text

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 ◽

Chronic Suppurative Otitis Media ◽

Age Group ◽

Hearing Improvement ◽

Suppurative Otitis Media ◽

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.

Download Full-text

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 ◽

Chronic Suppurative Otitis Media ◽

Hearing Improvement ◽

Suppurative Otitis Media ◽

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.

Download Full-text

Mobile, one stage, bilateral ear surgery for chronic otitis media patients in remote areas

The Journal of Laryngology & Otology ◽

10.1017/s0022215109005738 ◽

2009 ◽

Vol 123 (10) ◽

pp. 1108-1113 ◽

Cited By ~ 5

Author(s):

P Homøe ◽

H C Florian Sørensen ◽

M Tos

Keyword(s):

Otitis Media ◽

Pure Tone ◽

Chronic Otitis Media ◽

Ear Surgery ◽

Suppurative Otitis Media ◽

Remote Areas ◽

Pure Tone Average ◽

One Stage ◽

Air Conduction

AbstractObjectives:We evaluated the results of mobile, one stage, bilateral ear surgery conducted in Greenland, where chronic otitis media with and without suppuration is prevalent. The study aimed to increase the number of operations conducted and to reduce the cost of ear surgery in remote areas.Materials and methods:The study was longitudinal and prospective, with a two-year follow up. Seventeen East Greenlandic patients with bilateral chronic suppurative otitis media or chronic otitis media were selected. Their median age was 16 years; 53 per cent were female and 47 per cent male. Hearing was assessed using median air conduction pure tone average gain, and the ‘take rate’ (i.e. the percentage of total ears with a closed perforation) was evaluated.Results:All patients attended for follow up. Eighty-two per cent had at least one perforation closed, and the overall take rate was 65 per cent of the 34 ears. The median air conduction pure tone average gain after two years was 18 dB and 13 dB for the right and left ears, respectively. Fourteen patients (82 per cent) obtained an air conduction pure tone average hearing level of ≤25 dB in at least one ear. In total, 71 per cent of the patients were satisfied. There were no hearing hazards.Conclusions:The results of mobile, one stage, bilateral ear surgery conducted in Greenland for long-lasting chronic suppurative otitis media and chronic otitis media were acceptable and safe, and more ears underwent surgery at reduced cost compared with unilateral ear surgery.

Download Full-text

Periorbital Ecchymosis and Subconjunctival Hemorrhage following Ear Surgery

ISRN Otolaryngology ◽

10.1155/2013/791068 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Mohsen Rajati ◽

Mehdi Bakhshaee ◽

Kamran Khazaeni

Keyword(s):

Otitis Media ◽

Retrospective Review ◽

Complete Recovery ◽

Chronic Suppurative Otitis Media ◽

Ear Surgery ◽

Suppurative Otitis Media ◽

Subconjunctival Hemorrhage ◽

Complications Of Surgery ◽

Pathophysiologic Mechanisms

Objective. To evaluate the occurrence of two periorbital complications of surgery for Chronic Suppurative Otitis Media (CSOM) and discuss the potential pathophysiologic mechanisms. Materials and Methods. This is a retrospective review of the CSOM surgeries performed between Oct, 2005, and Jan, 2011, in our hospital. The early postoperative conditions of the patients were scrutinized to identify periorbital ecchymosis and subconjunctival hemorrhage. Results. Eight cases out of 756 patients were noted to have periorbital ecchymosis, and two of the patients also had simultaneous subconjunctival hemorrhage. All cases in which the complications occurred had undergone tympanoplasty, and in three patients mastoidectomy had also been performed. The age of the affected patients ranged from 24 to 70 years old. In all of them the condition ensued the day after the surgery and became better within 5 to 10 days. Complete recovery took approximately 1 month. Conclusion. Periorbital ecchymosis and subconjunctival hemorrhage are rare but safe complications of ear surgeries. The conditions are self-limiting and no management is necessary.

Download Full-text