scholarly journals Hearing Results After Type I Tympanoplasty With Versus Without Mastoidectomy

2021 ◽  
Vol 64 (11) ◽  
pp. 785-791
Author(s):  
Jun Young Lee ◽  
Sung-Kwang Hong ◽  
Hyo-Jeong Lee ◽  
Jong Kyou Lee ◽  
Hyung-Jong Kim
Keyword(s):  
Chronic Otitis Media ◽  
Type I ◽  
Mastoid Pneumatization ◽  
Hearing Results ◽  
Factors Affecting ◽  
Hearing Outcome ◽  
Canal Diameter ◽  
Group A ◽  
Group B

Background and Objectives The purpose of the mastoidectomy and tympanoplasty is to improve the hearing by removing the middle ear lesion and reconstructing the hearing mechanism. The purpose of this study is to verify whether several factors, including the presence of mastoidectomy can affect the hearing outcome of tympanoplasty patients.Subjects and Method From 1989 to 2018, 1260 patients with chronic otitis media who had been followed up for more than 6 months after type 1 tympanoplasty were selected. The each patient group was divided into 2 groups based on the last audiometry; Group A (post operative air-bone gap [ABG] ≤10 dB HL) and Group B (post operative ABG >10 dB HL). We analyzed the various factors including patency of E-tube or mastoid aeration for each group to figure out which factors affect the post operative hearing outcome.Results In conclusion, even with mastoidectomy, the final hearing after surgery was worse than that of the group who underwent tympanoplasty only (final ABG; tympanoplasty only vs. tympanoplasty with mastoidectomy; 6.59±9.09 vs. 9.71±8.94). In both with and without mastoidectomy group, the size of the perforation and external ear canal diameter before surgery did not affect the final hearing outcome. On the otherhand, in the group with mastoidectomy, mastoid pneumatization and E-tube patency affected the postoperative prognosis, but not in the case without mastoidectomy.Conclusion In this study, the factors affecting postoperative hearing success were analyzed. The results can be used to predict the postoperative hearing prognosis and to help select surgical treatment.

scholarly journals An observational study of endoscopic versus microscopic type I tympanoplasty in tubotympanic chronic otitis media in a tertiary health care centre

2021 ◽  
Vol 7 (3) ◽  
pp. 434
Author(s):  
Amrita Chowdhury ◽  
Shatabdi Das
Keyword(s):  
Observational Study ◽  
Hospital Stay ◽  
Otitis Media ◽  
Chronic Otitis Media ◽  
Type I ◽  
Advantages And Disadvantages ◽  
Type 1 Tympanoplasty ◽  
Group A ◽  
Group B

<p class="abstract"><strong>Background:</strong> Chronic otitis media (COM) is a widespread disease in the developing countries. It is treated by tympanoplasty, traditionally performed with the microscope which limits the visual field in the deep recesses of the middle ear, especially in narrow external auditory canal. Using endoscope has minimised these difficulties by providing a wide field view with angled magnification, reducing the duration of surgery. The advantages and disadvantages of both techniques is evaluated in our study.</p><p class="abstract"><strong>Methods:</strong> In this observational study, 60 patients of tubotympanic COM between 12-60 years of age with small to medium sized central perforation and air-bone gap of less than 45 decibel were included. They were divided into two groups (group A and group B) of 30 patients each. Group A underwent microscopic type 1 tympanoplasty and group B underwent endoscopic type 1 tympanoplasty. The duration of the surgery, the post-operative improvement in hearing and the graft uptake was analysed after 3 months of surgery. The post-operative hospital stay duration was noted.  </p><p class="abstract"><strong>Results:</strong> The post-operative hearing improvement and the graft uptake after 3 months of the surgery was statistically not significant between the two groups. But the mean duration of the operation and the post-operative hospital stay was significantly lower in the endoscopic group with a p value &lt;0.05.</p><p class="abstract"><strong>Conclusions:</strong> Endoscopes are better in otological procedures as it reduces the surgical duration, provides better visibility, lessens the post-operative hospital stay, reducing the economic burden of the patient.</p>

Comparative Study of effectiveness of mobilization with movement (MWM) and End range mobilization (ERM) techniques in frozen shoulder

2018 ◽  
Vol 4 (4) ◽  
pp. 519-522
Author(s):  
Jeyakumar S ◽  
Jagatheesan Alagesan ◽  
T.S. Muthukumar
Keyword(s):  
Range Of Motion ◽  
Frozen Shoulder ◽  
Type I ◽  
Mean Values ◽  
Functional Activities ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Frozen shoulder is disorder of the connective tissue that limits the normal Range of motion of the shoulder in diabetes, frozen shoulder is thought to be caused by changes to the collagen in the shoulder joint as a result of long term Hypoglycemia. Mobilization is a therapeutic movement of the joint. The goal is to restore normal joint motion and rhythm. The use of mobilization with movement for peripheral joints was developed by mulligan. This technique combines a sustained application of manual technique “gliding” force to the joint with concurrent physiologic motion of joint, either actively or passively. This study aims to find out the effects of mobilization with movement and end range mobilization in frozen shoulder in Type I diabetics. Materials and Methods: 30 subjects both male and female, suffering with shoulder pain and clinically diagnosed with frozen shoulder was recruited for the study and divided into two groups with 15 patients each based on convenient sampling method. Group A patients received mobilization with movement and Group B patients received end range mobilization for three weeks. The outcome measurements were SPADI, Functional hand to back scale, abduction range of motion using goniometer and VAS. Results: The mean values of all parameters showed significant differences in group A as compared to group B in terms of decreased pain, increased abduction range and other outcome measures. Conclusion: Based on the results it has been concluded that treating the type 1 diabetic patient with frozen shoulder, mobilization with movement exercise shows better results than end range mobilization in reducing pain and increase functional activities and mobility in frozen shoulder.

scholarly journals Hearing preservation after Gamma Knife radiosurgery for cerebellopontine angle meningiomas

2018 ◽  
Vol 129 (Suppl1) ◽  
pp. 38-46 ◽  
Author(s):  
Amr M. N. El-Shehaby ◽  
Wael A. Reda ◽  
Khaled M. Abdel Karim ◽  
Ahmed M. Nabeel ◽  
Reem M. Emad Eldin ◽  
...  
Keyword(s):  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
Hearing Preservation ◽  
Tumor Control ◽  
Factors Affecting ◽  
Hearing Outcome ◽  
Group A ◽  
Group B ◽  
Preservation Rate

OBJECTIVEThe objective of this study was to assess hearing function after Gamma Knife treatment of cerebellopontine angle (CPA) meningiomas and assess factors affecting hearing outcome. Additionally, the authors opted to compare these results with those after Gamma Knife treatment of vestibular schwannomas (VSs), because most of the information on hearing outcome after stereotactic radiosurgery (SRS) comes from reports on VS treatment. Hearing preservation, to the best of the authors’ knowledge, has never been separately addressed in studies involving Gamma Knife radiosurgery (GKRS) for CPA meningiomas.METHODSThis study included all patients who underwent a single session of GKRS between 2002 and 2014. The patients were divided into two groups. Group A included 66 patients with CPA meningiomas with serviceable hearing and tumor extension into the region centered on the internal auditory meatus. Group B included 144 patients with VSs with serviceable hearing. All patients had serviceable hearing before treatment (Gardner-Robertson [GR] Grades I and II). The median prescription dose was 12 Gy (range 10–12 Gy) in both groups. The median follow-up of groups A and B was 42 months (range 6–149 months) and 49 months (range 6–149 months), respectively.RESULTSAt the last follow-up, the tumor control rate was 97% and 94% in groups A and B, respectively. Hearing preservation was defined as maintained serviceable hearing according to GR hearing score. The hearing preservation rate was 98% and 66% and the 7-year actuarial serviceable hearing preservation rate was 75% and 56%, respectively, between both groups. In group A, the median maximum cochlear dose in the patients with stable and worsened hearing grade was 6.3 Gy and 5.5 Gy, respectively. In group B, factors affecting hearing preservation were cochlear dose ≤ 7 Gy, follow-up duration, and tumor control. The only determinant of hearing preservation between both groups was tumor type.CONCLUSIONSGKRS for CPA meningiomas provides excellent hearing preservation in addition to high tumor control rate. Hearing outcome is better with CPA meningiomas than with VSs. Further long-term prospective studies on determinants of hearing outcome after GKRS for CPA meningiomas should be conducted.

scholarly journals Comparative study of tympanoplasty type I using periosteum versus tragal cartilage with perichondrium

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Mohamed M. Elmoursy ◽  
Mahmoud M. Elbahrawy
Keyword(s):  
Comparative Study ◽  
Otitis Media ◽  
Type I ◽  
Suppurative Otitis Media ◽  
Hearing Results ◽  
Cartilage Grafts ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Grafting Materials

Abstract Background Various grafting materials and different techniques have been used for myringoplasty. The aim of the study was to compare the result of tympanoplasty in patients with safe-type chronic suppurative otitis media using periosteum versus tragal cartilage with perichondrium grafts through pre- and postoperative clinical and audiological evaluation. Results There was statistically significant difference for mean air-bone gap for group A (23.4 dB ± 0.03 SD) when compared to group B (19.4 dB ± 4.2 SD) with P value 0.103. Also, there was statistically significant difference in the hearing gain in group A after 6 months (25.53 dB ± 6.26 SD) when compared to group B (19.63 dB ± 9.76 SD) and the P value was 0.003. Graft taken was superior in the periosteal group (95%), compared to the cartilage grafts (90%). Conclusion Tympanoplasty with periosteal graft showed better hearing results and high rates of graft taken than tragal cartilage grafts.

scholarly journals Role of Cortical Mastoidectomy in the Management of Safe Chronic Otitis Media

2020 ◽  
Vol 18 (1) ◽  
pp. 44-48
Author(s):  
Lok Ram Verma ◽  
Dhundi Raj Paudel
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Inactive Disease ◽  
Type I ◽  
Hearing Improvement ◽  
Beneficial Effects ◽  
Cortical Mastoidectomy ◽  
Group A ◽  
Group B

Introduction: Role of cortical mastoidectomy in tympanoplasty for Chronic Otitis Media Mucosal inactive disease is controversial. Some arguments are in favor and suggest that cortical mastoidectomy increases the air reservoir in the mastoid and also help in achieving the patency of aditus but others believe that the ingrowths of squamous epithelium, potential for injury to the inner ear structures and facial nerve during mastoid surgery outweighs the beneficial effects on tympanic membrane healing. Aims: To assess the hearing improvement and graft uptake in patients undergoing Tympanoplasty and Tympano-mastoidectomy in chronic otitis media mucosal inactive disease. Methods: This was a comparative study comprises of 50 patients with Chronic Otitis Media Mucosal inactive ear, conducted in the patients attending the department of ENT in NGMC teaching hospital from Nov 2017 to May 2019. All cases were operated during a period of one half year. 25 patients were selected for tympanoplasty (Group A) and 25 patients were selected for Tympanoplasty with cortical mastoidectomy (Group B). Results: There were 14(28%) male and 36(72%) female, with mean age of 28. 36 years, ranging from minimum of 13 years to maximum 56 years. The postoperative audiograms were recorded after 3 months. Type I tympanoplasty with cortical mastoidectomy has better graft uptake (96%) as compared to without mastoidectomy (84%). Post-operative hearing improvement is almost equal in tympano-mastoidectomy (13.24 dB) and tympanoplasty (13.04 dB). Conclusion: Post-operative hearing gain almost equal in both study group but graft uptake was better with tympano-mastoidectomy then tympanoplasty alone in present study.

scholarly journals Audiological evaluation in between patients with type 1 tympanoplasty alone and type 1 tympanoplasty with cortical mastoidectomy

2017 ◽  
Vol 4 (1) ◽  
pp. 45
Author(s):  
K. Mallikarjuna Swamy ◽  
Arati Ganiger
Keyword(s):  
Hearing Loss ◽  
Pure Tone Audiometry ◽  
Type I ◽  
Hearing Improvement ◽  
Temporalis Fascia ◽  
Type 1 Tympanoplasty ◽  
Postoperative Assessment ◽  
Group A ◽  
Group B

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Evaluation of success of tympanoplasty depends on various host and surgical factors has been subject of interest for many years and still continues to be challenge</span><span lang="EN-IN">. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">Present study was undertaken to observe results of type I tympanoplasty using tragal cartilage and perichondrium with temporalis fascia grafts using endomeatal and postauricular approach.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Study group comprises of 30 patients in Group A and B operated by tympanoplasty type I by endomeatal and postauricular techniques. Success was 96.3% in Group A and 94.7% in Group B for closure of membrane perforation.<strong> </strong>During postoperative period average time taken for wound healing was 23 days in Group A and 35 days in Group B. Preoperative and postoperative assessment of hearing performed with pure tone audiometry revealed an average hearing loss of 36.50 dB in Group A before surgery and postoperative assessment at end of 1 year revealed hearing improvement of 14.23 dB. In Group B preoperative assessment revealed hearing loss of 38.23 dB lowered to 15.12 dB after surgery. When hearing improvement in both groups were compared preoperatively and postoperatively, in Group A there was improvement of 22.27 dB while in Group B was 23.11 dB. The hearing improvements in both the groups appear to be similar when the results were compared. In present study overall success rate was 89.7% which is comparable to outcome of surgery performed with post auricular approach with temporalis fascia graft which is 91.3%. When postoperative complications were studied it was observed that Group A had fewer numbers of complications as over Group B which was documented in Table 2. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Success of tympanoplasty depends on several host and surgical factors. Tragal perichondrium appears as proven alternate for closure of perforation of tympanic membrane. Cosmetically endomeatal approach appears promising over post auricular approach.</span></p>

scholarly journals Comparative study of outcomes of type-1 tympanoplasty with temporalis fascia only and with cartilage slice reinforcement

2020 ◽  
Vol 6 (6) ◽  
pp. 1162
Author(s):  
Shiv Kumar Rathaur
Keyword(s):  
Uptake Rate ◽  
Uttar Pradesh ◽  
Type I ◽  
Temporalis Muscle ◽  
Temporalis Fascia ◽  
Muscle Fascia ◽  
Group A ◽  
Group B ◽  
Cartilage Slice

<p class="abstract"><strong>Background:</strong> Tympanoplasty is a surgical procedure performed to eradicate infection and restore the function of middle ear. Cartilage slice support offers an extremely reliable method for reconstruction of tympanic membrane in cases of high-risk perforation. The purpose of this study was to evaluate the graft uptake and auditory outcomes of type I tympanoplasty using temporalis muscle fascia only and with cartilage slice reinforcement.</p><p class="abstract"><strong>Methods:</strong> This prospective study was conducted at the Department of Otorhinolaryngology, Government Medical College, Jalaun, Uttar Pradesh, India from November 2016 to November 2019. There were total of 100 patients, divided in two groups, 50 patients in each group, tympanoplasty type-1 using only temporalis fascia (group-A) and tympanoplasty type-1 using temporalis fascia with cartilage slice reinforcement (group-B). The result was measured on graft uptake and hearing outcome at 6 months postoperatively.  </p><p class="abstract"><strong>Results:</strong> Overall graft uptake rate in group-A was 94%, whereas that in group-B was 100%. The age and sex had no significant effect on the success rate of surgery (p&gt;0.05) in group-A. The average air bone gap (ABG) decreased from 28.3 dB to 10 dB, in group-B, the average ABG was 28.3 dB preoperatively and reached 16.6 dB after surgery. The difference between the rates of ABG improvement in the two groups was significant (p&lt;0.01).</p><p class="abstract"><strong>Conclusions:</strong> Hearing improvements is better in tympanoplasty type-1 with a temporalis graft only then with cartilage slice reinforcement. However, the graft uptake rate is higher in cartilage reinforcement compare with temporalis muscle fascia only.</p><p class="abstract"> </p>

Microbiology of cerumen in patients with recurrent otitis externa and cases with open mastoidectomy cavities

2004 ◽  
Vol 118 (4) ◽  
pp. 260-262 ◽  
Author(s):  
Yavuz Selim Pata ◽  
Candan Öztürk ◽  
Yücel Akbaş ◽  
Murat Ünal ◽  
Kemal Görür ◽  
...  
Keyword(s):  
Staphylococcus Epidermidis ◽  
Otitis Externa ◽  
Chronic Otitis Media ◽  
Open Cavity ◽  
Microbial Flora ◽  
Microbial Count ◽  
Group A ◽  
The Common ◽  
The Mean ◽  
Group B

This study investigated the common flora of human cerumen in patients with recurrent otitis externa, and subjects who had been operated on and had an open mastoidectomy cavity from chronic otitis media.Cerumen samples were collected from three groups; group A (n = 20) consisted of patients with recurrent otitis externa, group B (n = 20) consisted of patients with an open cavity and group C (n = 30) consisted of healthy subjects.The mean of the microbial count was 3.4 × 104 in group A, 3.08 × 104 in group B and 2.48 × 104 in group C. The most commonly isolated microorganism from the three groups was Staphylococcus epidermidis. No growth was observed in five cases (25 per cent) in group A and in three cases (10 per cent) in group C. In groupB antimicrobial growth was observed in all samples. In 46 (65 per cent) of the cerumen samples,the isolates were monomicrobial and 24 (35 per cent) of the cerumen samples were polymicrobial. The isolates were polymicrobial in 65 per cent of group A, 20 per cent in group B and 23.3 per cent in group C.In the process of investigating the microbial flora of cerumen in all the three groups, microbial growth was observed from all the samples from patients with an open cavity, unlike the other groups, and it was determined that the group with recurrent external otitis had the most abundant microbial flora.

scholarly journals A COMPARISON BETWEEN SYNTHETIC AND BIOSYNTHETIC MESHES IN THE SURGICAL TREATMENT OF SEVERE GENITAL PROLAPSE: RESULTS AND COMPLICATIONS

2010 ◽  
Vol 23 (3) ◽  
pp. 21
Author(s):  
S. Dati ◽  
V. De Lellis ◽  
P. Palermo ◽  
G. Carta
Keyword(s):  
Genital Prolapse ◽  
Pelvic Organ ◽  
Wilcoxon Test ◽  
Type I ◽  
Replacement Surgery ◽  
Group A ◽  
Group B ◽  
Work Up

The effectiveness, tolerability and complications of two surgical procedures using prosthetic materials with different physical and structural properties were assessed with a full Urogynecology work-up, through a retrospective study of 158 patients with severe genital prolapse (POP-Q staging III-IV) selected from November 2006 to April 2009. Eighty-six patients underwent fascial replacement surgery with ProliftTM System with a dual transobturator access in the anterior district and a transperineal posterior access with a synthetic polypropylene type I mesh (Group A). Seventy-two patients who underwent pelvic organ prolapse surgery with Avaulta/Avaulta PlusTM System with a dual transobturator access in the anterior district and a dual transperineal posterior access with a biosynthetic polypropylene type I mesh coated with a film of hydrophilic porcine collagen were placed in Group B. There were no intra and postoperative complications. Results of mean 20.8 month follow-up showed an effective anatomical cure rate of 89.5% in group A and 86.1% in group B and a low percentage of erosive complications, 8.1% and 5.6% respectively. Validated questionnaires for prolapse, the UDI 6 s.f., the IIQ7 s.f. and the PISQ-12 all showed a statistically significant improvement of quality of life in patients undergoing the two procedures (Wilcoxon test: P&lt;0.001).

scholarly journals Maintenance treatment of diabetic patients, associating arterial obstructive tibio-peroneal disease

1995 ◽  
Vol 113 (1) ◽  
pp. 701-705
Author(s):  
Nelson Wolosker ◽  
Ruben Miguel Ayzin Rosoky ◽  
Baptista Muraco Neto ◽  
Berilo Langer
Keyword(s):  
Maintenance Treatment ◽  
Diabetic Patients ◽  
Type I ◽  
Group I ◽  
Significant Difference ◽  
Therapeutic Procedures ◽  
Arterial Pulsation ◽  
Group A ◽  
Group B ◽  
Better Than

When a melito-diabetic patient presents trophic infected injury on the limb, it is essential an evaluation of the circulatory conditions for therapeutic procedures orientation. In some circumstances, although arterial pulsation is absent, there is no ischemia of tissues. In these cases, the maintenance treatment, with eventual resection of the necrosed and infected tissues may be adopted. Evolution of 70 diabetic patients with trophic injuries on extremities were submitted to a maintenance treatment. Age of patients varied from 28 to 88 years, with an average of 56.8. The most occurrence was verified in women, with 42 cases. Diabetes non-dependant on insuline (type II) was observed in 64 patients (91.5%), being the remaining 6 patients of type I. Diabetic retinopathy was observed in 14 (20%) of the patients, neuropathy in 22 (31%) and nephropathy in 8 patients (11.4%). All the patients presented arterial pulsation until the popliteal region. They were divided in 2 groups, considering trunk arteries of legs: Group I, pervial legs arteries, composed by 48 patients; Group II, occluded legs arteries, with 22 patients. In what refers to the anatomic local of the injuries, patients were classified in three groups: Group A, formed by 32 patients (45.7%), presenting injuries in one or two toes only, without affecting the metatarsic region; Group B, formed by 16 patients (22.9%), trophic injuries affecting the metatarsic region and Group C, formed by 22 patients (31.4%), injuries affecting the calcaneous region. Injuries in both of the groups were caused by mechanical traumatism. Duration of the injury in the inferior member varied from 7 to 48 days, resulting in a 12 days average. Analyzing pervicacity in trunk arterias and evolution of patients, it may be observed that there has been a significantly better result in those with all the pulses present (81.3% x 45.5%)(p<0,01). Studying the injury locals associated to the evaluation of the cases, we may observe that for injuries in the extreme digital, result is significantly better than in locals more nearly. When distal pulses are absent, there is no significant difference in the result of the treatment, being performed in distal injuries or in the more near ones (p>0,05)(Table IV).

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