scholarly journals Operative Time and Tympanic Membrane Integrity in Endoscopic Transcanal versus Microscopic Post-Auricular Tympanoplasty for Chronic Otitis Media

2018 ◽  
Vol 33 (1) ◽  
pp. 25-29 ◽  
Author(s):  
Jenina Rachel D.J. Escalderon ◽  
William L. Lim
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Operative Time ◽  
Membrane Integrity ◽  
Chronic Otitis Media ◽  
Female Ratio ◽  
Significant Difference ◽  
Tertiary Hospitals ◽  
Microscopic Tympanoplasty ◽  
Endoscopic Tympanoplasty

Objective: To compare surgical outcomes (operative time and tympanic membrane integrity) obtained by endoscopic transcanal tympanoplasty (ET) and microscopic post-auricular tympanoplasty (MT) in patient with inactive chronic otitis media. Methods:             Design:            Retrospective Cohort             Setting:           Multicenter study in 3 Private Tertiary Hospitals               Participants: 18 patients who underwent microscopic or endoscopic tympanoplasty for chronic otitis media. Results: Each group had 9 patients, with median age of 43 (31-65 years) for the MT and 47 (29-59 years) for the ET group. There was no significant difference in median age of the two groups (Mann-Whitney U=17, P=.22).  Male: female ratio was (5:4) and (6:3) for the ET and MT group respectively, with no significant difference in gender distribution (c2= 0.90, P=.34). Mean operative time for the ET and MT group was 86.7 minutes and 140.6 minutes, respectively, with significantly lower mean operative time for the ET group (t= 3.57, P=.0025). There was complete tympanic membrane graft uptake in both groups.   Conclusion: Regardless of technique, tympanoplasty is an effective surgical treatment among patients with inactive chronic otitis media. Endoscopic tympanoplasty is an alternative to conventional microscopic tympanoplasty that may use less operative time, producing similarly complete graft uptake.   Keywords: chronic otitis media, tympanoplasty, endoscopic tympanoplasty, microscopic tympanoplasty, perforation, tympanic membrane

scholarly journals COMPARATIVE STUDY OF ENDOSCOPIC AND MICROSCOPIC ASSISTED MYRINGOPLASTY IN TIRUMALA HOSPITALS, KADAPA

2019 ◽  
Vol 3 (5) ◽  
Author(s):  
Dr. P. Surendra Babu
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Operative Time ◽  
Operating Time ◽  
Chronic Otitis Media ◽  
Ossicular Chain ◽  
Fascia Graft ◽  
Significant Difference ◽  
The Mean

Objective: The main aim of the study is to assess the operative time, graft uptake and audiological gain and post-operative scar in the group of the patients undergoing the endoscope assisted and the microscope assisted myringoplasty in Tirumala Hospital, Kadapa. Material and Methods: Myringoplasty or type-1 tympanoplasty was performed by either the endoscope or the microscope assistance. Postaural approach was undertaken for microscope assisted myringoplasty. Underlay technique of myringoplasty was performed using temporalis fascia graft in all the patients suffering from the inactive mucosal chronic otitis media. Post operative evaluation was done in terms of operative time, graft uptake and audiological gain. The patients were followed up for a period of 6 months. The study was longitudinal in nature and comprised of 100 patients suffering from the chronic otitis media inactive mucosal disease. The patients are divided into two groups consisting of 50 in each group. One group of patients have undergone microscopic assisted myringoplasty one group undergone endoscopic assisted myringoplasty and were followed up regularly.  Study period is one year from January 2016 to December 2016 attending outpatient otolaryngology department were included in the study. Results: The operative time in the patients undergoing the endoscope assisted myringoplasty(EAM) was 45minutes whereas it was 60 minutes in the patients undergoing the microscope assisted myringoplasty(MAM). The tympanic membrane graft uptake and audiological gain was assessed at 1 month, 3months and 6 months post operatively. The successful closure of the tympanic membrane perforation was higher with the endoscope assisted myringoplasty as compared to the microscope assisted myringoplasty at 1 month, 3 months and 6 months of follow up. The mean audiological gain following myringoplasty with both the techniques used was noted. The mean audiological gain was found to be marginally better with the endoscope assisted myringoplasty at follow up of 1, 3 and 6 months as compared to the microscope assisted myringoplasty. Conclusion: The operative time was less in the endoscope assisted technique as compared to the microscope assisted technique. The post operative morbidity (evaluated in terms of post operative scar) was less in the group of patients undergoing the Transcanal endoscope assisted as compared to microscope assisted myringoplasty. There was no significant difference in either graft uptake or post-operative audiological gain in the patients undergoing myringoplasty by endoscope assisted and microscope assisted technique. The endoscope assisted myringoplasty has advantages of better assessment of ossicular chain and in the patients with canal overhang it improves the visualisation of the margins of the perforation thus obviating the need for canalplasty. Thus the endoscope assisted myringoplasty can be used as a preferred alternative to the conventional microscope assisted myringoplasty, with better post operative results and reduced operating time and morbidity of the surgical procedure. Keywords: Chronic otitis media (COM); Myringoplasty; Endoscope assisted myringoplasty; Microscope assisted myringoplasty.

scholarly journals Descriptive study of various bacterial flora in chronic otitis media

2021 ◽  
Vol 7 (3) ◽  
pp. 463
Author(s):  
Rohan M. Dixith ◽  
Gundappa D. Mahajan ◽  
Sabreena Mukhtar ◽  
Shubhangi Prasad
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Middle Ear ◽  
Proteus Mirabilis ◽  
Bacterial Flora ◽  
Chronic Otitis Media ◽  
Age Group ◽  
Bacteriological Study ◽  
Female Ratio ◽  
Culture And Sensitivity

<p class="abstract"><strong>Background:</strong> Chronic otitis media (COM) is the inflammation of the middle ear, which is characterised by ear discharge due to tympanic membrane perforation, at least for over a month. The inflammation is due to the underlying infection, due to which the middle ear mucosa gets inflamed, leading to discharge and eventual perforation of the tympanic membrane. The aim of the study was to study the microbial flora and its culture and sensitivity from ear discharge in chronic otitis media.</p><p class="abstract"><strong>Methods:</strong> Total of 100 ears with either mucosal COM or squamosal COM were included in this study. Patients coming to the outpatient department (OPD) with discharging ear were subjected to aural suctioning/cleaning with the use of bulls eye lamp. After cleaning the external auditory canal, sterile aural speculum were introduced into the EAC, creating a sterile conduit. Following this, middle ear discharge or the discharge around the tympanic membrane was collected using sterile cotton swabs and sent for laboratory within half an hour for mycological and bacteriological study.</p><p class="abstract"><strong>Results: </strong>Majority of patients were in an age group of 10-20 years, followed by age group of 21-30 years. The male to female ratio was 4.7:5.3. Out of the 100 swabs sent for culture and sensitivity, 6 swabs had no growth whereas <em>Pseudomonas aeroginosa </em>was the highest isolated organism (36 swabs), followed by <em>Proteus mirabilis </em>(23 swabs). Aerobic infection was the commonest, isolated in 47.9% of culture positive swabs. Polymyxin B was the most sensitive antibiotic, whereas cefotaxime was the most resistant antibiotic.</p><p class="abstract"><strong>Conclusions:</strong> <em>Pseudomonas aeruginosa </em>and <em>Proteus mirabilis </em>are the main bacteria isolated in mucosal COM. There is development of drug resistance in the majority of bacteria in chronic otitis media, due to excessive usage of antibiotics, making the treatment much difficult.</p>

scholarly journals Comparative study between fat plug and inlay butterfly cartilage grafts for myringoplasty in adults

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Ahmed Gamal Khafagy ◽  
Mohamed El-Begermy ◽  
Marwa Mohamed El-Begermy ◽  
Pretty O. Afifi
Keyword(s):  
Tympanic Membrane ◽  
Chronic Otitis Media ◽  
Fat Graft ◽  
Cartilage Graft ◽  
Tympanic Membrane Perforations ◽  
Number Of Patients ◽  
Significant Difference ◽  
Hearing Outcomes ◽  
Age Range

Abstract Background This study aims to compare the graft uptake rate and hearing improvement of fat graft versus inlay butterfly tragal cartilage in the repair of perforations in chronic otitis media mucosal in adults. In this retrospective study, twenty-eight patients were included with small dry anteroinferior tympanic membrane perforations (less than 1/3 of the tympanic membrane). The age range was 18 to 44 years old. Myringoplasty was done under general anesthesia for 8 patients with a fat graft (FG) and 20 patients with inlay butterfly cartilage graft (IBCG). Six months postoperatively, a follow-up evaluation was done for successful graft uptake and hearing outcomes. Results The success rate of graft uptake in the first group (fat graft) was 6/8 cases (75%) while in the second group (IBCG) was 19/20 (95%) with no statistically significant difference (P = 0.0148). Also, there was no statistical difference between the two groups as regards postoperative ABG, improvement changes in ABG, and number of patients with improved hearing. Conclusions Inlay butterfly cartilage graft is a useful graft in repairing small tympanic membrane perforations as regard graft take and hearing outcomes.

scholarly journals Comparison of efficacy of myringoplasty in dry and wet ears in chronic otitis media of tubotympanic type

2017 ◽  
Vol 3 (3) ◽  
pp. 705 ◽  
Author(s):  
Yogeshwar Chandrashekar ◽  
Ravishankar Chandrashekar
Keyword(s):  
Otitis Media ◽  
Statistical Significance ◽  
Chronic Otitis Media ◽  
Pure Tone Audiometry ◽  
Inflammatory Cells ◽  
P Value ◽  
Hearing Improvement ◽  
Female Ratio ◽  
Fascia Graft ◽  
A Prospective Study

<p class="abstract"><strong>Background:</strong> The objective of the study was to compare the outcome of myringoplasty in dry and wet ears in tubotympanic type of chronic otitis media (COM) with respect to graft uptake and hearing improvement.</p><p class="abstract"><strong>Methods:</strong> This is a prospective study done in department of ENT Bangalore Medical College and Research Institute during the study period of November 2014 to May 2016, wherein a total of 60 patients of tubotympanic type COM with 30 cases each of dry and wet ears, aged 15-60 years were included. The hearing impairment was assessed and recorded by pure tone audiometry (PTA). After obtaining informed written consent the patients underwent myringoplasty (temporalis fascia graft, underlay technique). Microbiological examination of discharge in wet ears was done and histopathology of the excised remnant TM analyzed in both groups. Both groups of patients were followed up for 3 months and assessed for graft uptake and hearing improvement. PTA was repeated at 3 months postoperatively.  </p><p class="abstract"><strong>Results:</strong> Our study included 60 patients of tubotympanic type of COM with 30 cases each with dry and wet ears who underwent myringoplasty. Majority of our patients were in second decade in both the groups. There was slight female preponderance in our study with male to female ratio of 0.93:1. Discharge from ears in wet ears was mucoid in consistency and were culture negative. Histopathology of excised remnant TM in wet ears revealed evidence of inflammatory cells and vascularization within stroma of fibroblasts while these were absent in dry ear cases. The overall successful graft uptake following myringoplasty was 88.3% with 86.7% for wet ears and 90% for dry ears with no statistical significance (p value of 0.688&gt;0.05) between the two groups. With respect to hearing improvement post-operatively there was significant hearing improvement in both the groups when compared to preoperative hearing with a mean hearing gain (dB) of 3.43±2.81 in wet ear cases to 3.85±3.05 in dry ear cases, but when compared between the two groups, there was no significant statistical difference (p value of 0.582&gt;0.05).</p><p><strong>Conclusions:</strong> The outcome is equally good for myringoplasty in dry and wet ears in tubotympanic type of chronic otitis media with respect to graft uptake and hearing improvement. </p>

scholarly journals Evaluation of hearing status after type I tympanoplasty

2020 ◽  
Vol 24 (1) ◽  
pp. 50-55
Author(s):  
Mashuque Mahamud ◽  
Mani Lal Aich ◽  
Abdullah Al Mamun ◽  
Rafiul Alam
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Neck Surgery ◽  
Cross Sectional Study ◽  
Type I ◽  
Cross Sectional ◽  
Female Ratio ◽  
The Mean ◽  
Type I Tympanoplasty ◽  
Air Conduction

Objective: To evaluate hearing outcome after type I tympanoplasty in inactive mucous type of chronic otitis media. Methods: It was a cross-sectional study conducted in the department of Otolaryngology & Head Neck Surgery, Sir Salimullah Medical College and Mitford Hospital, Dhaka, from July 2014 to June 2016. 50 cases were selected by matching inclusion and exclusion criteria. Paired t-test and Z test was used to analyze the variables. P values <0.05 was considered as statistically significant. Results: The mean age was found 28.5 years with range from 15 to 41 years and male female ratio was 1.3:1. All patients had intermittent otorrhoea and varying degree of hearing loss. The mean air conduction threshold was 40.2 dB preoperatively and 27.1 dB post-operatively. Air-bone gap was found 26.9 dB in preoperative and 16.1 dB in post-operative group. The differences were statistically significant between preoperative and post-operative group. Thus mean improvement of air conduction threshold was 13.1 dB and air-bone gap was 10.8 dB. Two third (66.%) patients improved <15 db air conduction thresholds and 17(34%) improved ≥15 db air conduction thresholds. Using the proportion of patients with a postoperative hearing within 40 dB as the criterion, this study showed 46(92%) patients achieving this and 40(80%) patients achieving AB gap within 20 db postoperatively. Conclusion: Improvement of air conduction threshold and AB gap after type I tympanoplasty was statistically significant. Thus from this study it can be concluded that type I tympanoplasty is an effective technique for hearing improvement in inactive mucous type of chronic otitis media. Bangladesh J Otorhinolaryngol; April 2018; 24(1): 50-55

scholarly journals Cortical Mastoidectomy with Tympanoplasty in the Management of Chronic Mucosal Otitis Media

KYAMC Journal ◽  
2020 ◽  
Vol 11 (2) ◽  
pp. 91-95
Author(s):  
Muntasir Mahbub ◽  
Abdullah Al Zobair ◽  
Nabila Mannan ◽  
Md Mahmudul Haque ◽  
Khabir Uddin Ahmed
Keyword(s):  
Medical Treatment ◽  
Otitis Media ◽  
Chronic Otitis Media ◽  
Female Ratio ◽  
Hearing Status ◽  
Graft Take ◽  
Cortical Mastoidectomy ◽  
Treatment Objective ◽  
Male To Female ◽  
Study Inclusion

Background: Cortical mastoidectomy with tympanoplasty is considered the standard of treatment in case of active mucosal chronic otitis media, refractory to medical treatment. Objective: Aim for this study was to find out the efficacy of cortical mastoidectomy with tympanoplasty in the management of chronic mucosal otitis media. Materials and Methods: This is an observational study conducted from January 2016 to July 2016. Total 50 patients were included in this study. Inclusion criteria was diagnosed cases of mucosal chronic otitis media with persistent ear discharge, adequate medical treatment, age between 15-60 years of both sexes. All the patients underwent cortical mastoidectomy with tympanoplasty, and patients were followed up to 12 weeks to evaluate graft take rate and compare pre-operative and post-operative hearing status. Results: In this study male to female ratio was 1.17:1. Mean age of study group was 30.66 ( 9.62) years. Graft uptake was successful in 43 (87%) and in 07 (14%) graft didn't take. Graft take rate was highest in 15-30 years age group. Mean preoperative and post-operative air bone gap were 28.45 (7.69) dB and 25.30 ( 8.5) dB respectively. Conclusion: Cortical mastoidectomy with tympanoplasty shows good outcome in aspects of disease clearance and graft uptake success in chronic mucosal otitis media. Although hearing gain occurs in most cases, it is rather modest. KYAMC Journal Vol. 11, No.-2, July 2020, Page 91-95

Optimizing effectiveness of laser tympanic membrane fenestration in chronic otitis media with effusion

2001 ◽  
Vol 58 (1) ◽  
pp. 59-64 ◽  
Author(s):  
Linda Brodsky ◽  
Steve Cook ◽  
Ellen Deutsch ◽  
Patrick Brookhouser ◽  
Charles Bower ◽  
...  
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media
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