A STUDY OF DOUBLE CARTILAGE OSSICULOPLASTY
IN PATIENTS OF CHRONIC SUPPURATIVE OTITIS MEDIA

Introduction: This retrospective study is based on assessment of hearing in patients of chronic suppurutive otitis media by double cartilage ossiculoplasty at MEHROTRA ENT HOSPITAL KANPUR. Materials and Methods: 100 patients of CSOM who were operated at MEHROTRA ENT HOSPITAL KANPUR with double cartilage ossiculoplasty were included in the study. Results were analyzed by comparing the air bone gap pre and post operatively after one year. Results: With Double cartilage ossiculoplasty postoperative hearing assessed after 1 year improved signi􀃶cantly. Conclusion : Double cartilage ossiculoplasty represents an excellent alternative to prosthesis for ossicular reconstruction in severe chronic otitis media. Long term hearing outcome improved signi􀃶cantly and remain stable and satisfactory. It is also cost effective. Keywords Double Cartilage, Ossiculoplasty, Otitis Media

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An Analytical Study of the Factors Affecting Hearing Improvement after Ossiculoplasty – A Retrospective Study, Mathura, Uttar Pradesh

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/568 ◽

2021 ◽

Vol 8 (33) ◽

pp. 3123-3127

Author(s):

Piyush Kant Singh ◽

Samneet Saggu ◽

Preeti Singh

Keyword(s):

Retrospective Study ◽

Otitis Media ◽

Ossicular Chain ◽

Chronic Suppurative Otitis Media ◽

Hearing Improvement ◽

Suppurative Otitis Media ◽

Hearing Outcome ◽

Implant Material ◽

Ossicular Replacement ◽

Replacement Prosthesis

BACKGROUND Otologists always yearn to improve the hearing outcome of their patients with chronic suppurative otitis media. There are different options for ossiculoplasty to choose from, depending on the extent of disease, condition of ossicular chain and availability of implant material and there has always been a quest to make appropriate decision with a predictable outcome. In this study, we have tried to analyse various factors which can affect hearing outcome after Ossiculoplasty. METHODS A retrospective study was done to study the effect of implant material, condition of ossicular chain and disease in the mastoid on post-operative hearing improvement on 200 patients, who underwent tympanoplasty or tympanomastoidectomy from January 2018 to January 2020, in Department of Otorhinolaryngology and Head and Neck Surgery, K.D. Medical College, Mathura. Decision of ossiculoplasty was made based on intra-operative findings. Autograft incus, Teflon TORP (total ossicular replacement prosthesis) and cartilage columella were used based on availability and feasibility. RESULTS Mean improvement in average air-bone gap of 200 patients was found to be 18.57 dB, with autograft incus, it was 19.99 dB, with Teflon TORP (total ossicular replacement prosthesis), 19.53 dB and with cartilage columella 16.73 dB (P = 0.023). Mean hearing improvement was 18.98 dB when handle of malleus was present and 15.59 dB when it was absent (P = 0.023). Mean hearing improvement was 19.42 dB when stapes superstructure was present and 16.92 dB when it was absent (P = 0.016). Even though the hearing outcome was better when mastoid was disease free (19.57 dB) compared to when it was diseased (18.30 dB), the difference was not statistically significant. (P = 0.177) CONCLUSIONS In our study, we found autograft incus to be the best material for ossiculoplasty and presence of handle of malleus and stapes superstructure improved postoperative hearing outcome significantly but involvement of mastoid by disease did not significantly affect the hearing outcome post-operatively. KEYWORDS Chronic Suppurative Otitis Media, Ossiculoplasty, Tympanoplasty, Ossicular Prosthesis, Autograft

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Development of an ear cap in chronic suppurative otitis media using additive manufacturing and TRIZ

Proceedings of the Institution of Mechanical Engineers Part H Journal of Engineering in Medicine ◽

10.1177/0954411918780126 ◽

2018 ◽

Vol 232 (7) ◽

pp. 733-738 ◽

Cited By ~ 1

Author(s):

Mahesh B Mawale ◽

Abhaykumar Kuthe ◽

Anupama M Mawale ◽

Sandeep W Dahake

Keyword(s):

Hearing Loss ◽

Additive Manufacturing ◽

Otitis Media ◽

Middle Ear ◽

Prevalence Rate ◽

Chronic Otitis Media ◽

Chronic Suppurative Otitis Media ◽

Suppurative Otitis Media ◽

Collaborative Tool ◽

Middle Ear Infection

The prevalence rate of chronic suppurative otitis media is high and its treatment continues to be a challenge for the otorhinolaryngologists. Due to middle ear infection, there may be pain, hearing loss and spontaneous rupture of the eardrum which results in perforation. Infections can cause a hole in the eardrum as a side effect of otitis media. The patients suffering from ear perforation or having a hole in eardrum require preventing entry of water in the ear. This article describes the development of ear cap using additive manufacturing and TRIZ (a collaborative tool) to prevent the entry of water in the ear during chronic otitis media.

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Silencing Nrf2 attenuates chronic suppurative otitis media by inhibiting pro-inflammatory cytokine secretion through up-regulating TLR4

Innate Immunity ◽

10.1177/1753425920933661 ◽

2020 ◽

Vol 27 (1) ◽

pp. 70-80

Author(s):

Abulajiang Tuoheti ◽

Xingzhi Gu ◽

Xiuqin Cheng ◽

Hua Zhang

Keyword(s):

Chronic Inflammation ◽

Otitis Media ◽

Inflammatory Cytokines ◽

Inflammatory Cytokine ◽

Acute Otitis Media ◽

Chronic Otitis Media ◽

Chronic Suppurative Otitis Media ◽

Related Factor ◽

Suppurative Otitis Media ◽

Knock Down

Compromised TLR-mediated chronic inflammation contributes to bacterial infection-caused chronic suppurative otitis media, but the mechanisms are unclear. The present study examined the expression status of nuclear erythroid 2-related factor 2 (Nrf2) and TLRs in human middle-ear mucosae tissues collected from patients with chronic suppurative otitis media, chronic otitis media and non-otitis media, and found that Nrf2 was high-expressed, whereas TLR4, instead of other TLRs, was low expressed in chronic suppurative otitis media compared to chronic otitis media and non-chronic otitis media groups. Consistently, inflammatory cytokines were significantly up-regulated in the chronic suppurative otitis media group, instead of the chronic otitis media and non-chronic otitis media groups. Next, LPS-induced acute otitis media and chronic suppurative otitis media models in mice were established, and high levels of inflammatory cytokines were sustained in the mucosae tissues of chronic suppurative otitis media mice compared to the non-otitis media and acute otitis media groups. Interestingly, continuous low-dose LPS stimulation promoted Nrf2 expression, but decreased TLR4 levels in chronic suppurative otitis media mice mucosae. In addition, knock-down of Nrf2 increased TLR4 expression levels in chronic suppurative otitis media mice, and both Nrf2 ablation and TLR4 overexpression inhibited the pro-inflammatory cytokine expression in chronic suppurative otitis media. Finally, we found that both Nrf2 overexpression and TLR4 deficiency promoted chronic inflammation in LPS-induced acute otitis media mice models. Taken together, knock-down of Nrf2 reversed chronic inflammation to attenuate chronic suppurative otitis media by up-regulating TLR4.

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Investigation of the Presence of Biofilms in Chronic Suppurative Otitis Media, Nonsuppurative Otitis Media, and Chronic Otitis Media with Cholesteatoma by Scanning Electron Microscopy

The Scientific World JOURNAL ◽

10.1155/2013/638715 ◽

2013 ◽

Vol 2013 ◽

pp. 1-6 ◽

Cited By ~ 17

Author(s):

Ercan Kaya ◽

Ilknur Dag ◽

Armagan Incesulu ◽

Melek Kezban Gurbuz ◽

Mustafa Acar ◽

...

Keyword(s):

Electron Microscopy ◽

Scanning Electron Microscopy ◽

Otitis Media ◽

Middle Ear ◽

Chronic Otitis Media ◽

Chronic Suppurative Otitis Media ◽

Middle Ear Mucosa ◽

Suppurative Otitis Media ◽

Tissue Samples ◽

Scanning Electron

Objective. Biofilms have been shown to play a major role in the pathogenesis of otolaryngologic infections. However, very limited studies have been undertaken to demonstrate the presence of biofilms in tissues from patients with chronic otitis media (COM) with or without cholesteatoma. Our objective is to study the presence of biofilms in humans with chronic suppurative and nonsuppurative otitis media and cholesteatoma.Study Design. In all, 102 tissue specimens (middle ear, mastoid tissue, and ossicle samples) were collected during surgery from 34 patients.Methods. The samples were processed for the investigation of biofilms by scanning electron microscopy (SEM).Results. Our research supports the hypothesis in which biofilms are involved in chronic suppurative otitis media, cholesteatoma, and, to a lesser degree, chronic nonsuppurative otitis media. There were higher rates in hypertrophic and granulated tissue samples than in normal mucosa. In addition, the presence of biofilms was significantly higher in the middle ear mucosa compared with the mastoid and ossicle samples.Conclusion. In the clinic, the careful use of topical or systemic antimicrobials is essential, and, during surgery, hypertrophic tissue must be carefully removed from normal tissue.

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Effect of aerobic bacteriology on the clinical presentation and treatment results of chronic suppurative otitis media

The Journal of Laryngology & Otology ◽

10.1017/s0022215100133535 ◽

1996 ◽

Vol 110 (4) ◽

pp. 315-318 ◽

Cited By ~ 19

Author(s):

Eero Vartiainen ◽

Jukka Vartiainen

Keyword(s):

Surgical Treatment ◽

Otitis Media ◽

Clinical Presentation ◽

Chronic Suppurative Otitis Media ◽

Long Term Results ◽

Treatment Results ◽

Suppurative Otitis Media ◽

Hearing Results ◽

Significant Difference

AbstractThe effect of aerobic bacteriology on the clinical presentation, complications of the disease and long-term results of surgical treatment was assessed in a cohort of 368 patients with chronic suppurative otitis media. Bacteriological findings showed no significant difference between child and adult patients. Staphylococcus aureus was isolated in cholesteatoma ears more frequently than Pseudomonas aeruginosa, in chronic ears without cholesteatoma the situation was reversed. Bacteriological findings had no significant effect on the incidence of complications caused by the disease. Failures after surgical treatment were most common in Pseudomonas ears. The bacteriology had no significant effect on pre-operative hearing levels nor postoperative hearing results. It was concluded that, in order to improve results of chronic ear sugery, more attention should be paid to pre-operative conservative treatment of chronically discharging ears, especially those infected by P. aeruginosa.

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Development and Administration of Chronic Suppurative Otitis Media Questionnaire-12 (COMQ-12) and Chronic Otitis Media Outcome Test-15 (COMOT-15) in Kannada

International Archives of Otorhinolaryngology ◽

10.1055/s-0037-1603644 ◽

2017 ◽

Vol 22 (02) ◽

pp. 108-112 ◽

Cited By ~ 6

Author(s):

Prashanth Prabhu ◽

Anusha Chandrashekar ◽

Anita Jose ◽

Aishwarya Ganeshan ◽

Lavanya Kiruthika

Keyword(s):

Quality Of Life ◽

Otitis Media ◽

Chronic Otitis Media ◽

Chronic Suppurative Otitis Media ◽

Health Related Quality ◽

Suppurative Otitis Media ◽

Related Quality ◽

Health Related ◽

Significant Impairment

Introduction It is essential to determine the quality of life among individuals with chronic suppurative otitis media (CSOM). However, there is limited literature on health-related quality of life measurements in Kannada-speaking individuals with CSOM. Objectives The present study attempted to translate and validate Chronic Suppurative Otitis Media Questionnaire-12 (COMQ-12) and Chronic Otitis Media Outcome Test-15 (COMOT-15) in Kannada. Method The English questionnaires were translated and back-translated, and they were later verified for content validity. The developed questionnaires were then administered to 100 individuals with CSOM for further validation. Results The results of the study showed that the translated questionnaires have good internal consistency for measuring quality of life among individuals with CSOM. The study also showed that Kannada-speaking individuals with CSOM show significant impairment in their health-related quality of life measures. Conclusions The impairments were more related to ear symptoms and psychological issues. However, test-retest reliability of the developed questionnaire and its further validation are essential. Thus, these questionnaires attempt to understand the problems of the individuals with CSOM from the patients' perspective and help clinicians provide the appropriate management.

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Cost-Utility Analysis of Tympanomastoidectomy for Adults with Chronic Suppurative Otitis Media

Otolaryngology ◽

10.1016/j.otohns.2005.05.045 ◽

2005 ◽

Vol 133 (3) ◽

pp. 352-356 ◽

Cited By ~ 8

Author(s):

Pa-Chun Wang ◽

Chul-Ho Jang ◽

Yu-Hsiang Shu ◽

Chih-Jaan Tai ◽

Ko-Tsung Chu

Keyword(s):

Otitis Media ◽

Health Care Cost ◽

Cost Effective ◽

Cost Utility ◽

Cost Utility Analysis ◽

Chronic Suppurative Otitis Media ◽

Total Direct Cost ◽

Utility Analysis ◽

Suppurative Otitis Media ◽

Utility Gain

OBJECTIVE: To undertake cost-utility analysis for tympanomastoid surgery to analyze its cost-effectiveness in treating adult chronic suppurative otitis media (CSOM). METHODS: Seventy-seven patients with CSOM were evaluated with the Chronic Ear Survey (CES) before and 1 year after tympanomastoid surgery. Direct health care cost data during the 1st year after operation were retrieved. The utility gain was defined as change in the CES total score. The cost-utility ratio (CUR) was defined as cost per utility gain. Patients were stratified by disease type into wet-ear and dry-ear groups. RESULTS: The average total direct cost attributable to tympanomastoid surgery is (in New Taiwan dollars [NT$]) 45,716.3 in the 1st postoperative year, and the average CUR is NT$ 1850.9. The lower CUR of NT$ 1280.9 for the wet-ear group is due to the greater utility gain (37.6 ± 3.4 versus 24.4 ± 6.8, P >0.05) despite its higher cost (NT$ 48,163.2 versus NT$ 38,419.7, P >0.05). CONCLUSIONS: Treating continuously or intermittently draining ears is more cost-effective, as compared with managing a quiescent infection, because of its favorable utility gain.

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Relationship of Pure Tone Audiometry and Ossicular Discontinuity in Chronic Suppurative Otitis Media

Philippine Journal of Otolaryngology Head and Neck Surgery ◽

10.32412/pjohns.v21i1-2.819 ◽

2006 ◽

Vol 21 (1-2) ◽

pp. 5-10

Author(s):

Ryner Jose C. Carrillo ◽

Nathaniel W. Yang ◽

Generoso T. Abes

Keyword(s):

Logistic Regression ◽

Otitis Media ◽

Pure Tone ◽

Operative Procedure ◽

Multiple Logistic Regression Analysis ◽

Chronic Otitis Media ◽

Pure Tone Audiometry ◽

Chronic Suppurative Otitis Media ◽

Likelihood Ratios ◽

Suppurative Otitis Media

Background: Pure tone audiometry is routinely used to determine conductive and sensorineural hearing status. Ossicular discontinuity is usually assessed intra-operatively. If ossicular discontinuity can be predicted by pure tone audiometry, perhaps the operative procedure of choice and prognosis for hearing can also be anticipated. Objective: To determine the predictive value of preoperative pure tone audiometry on the presence of gross ossicular discontinuity in chronic otitis media. Methods: Records of 205 patients, 7 to 75 years of age undergoing their first operation for chronic otitis media were reviewed. Preoperative audiograms and operative records for tympanomastoidectomy were evaluated. A total of 162 patients meeting inclusion criteria were included in the study. Likelihood ratios for positive and negative ossicular discontinuity for frequency-specific air-bone gap cut-offs were determined. Multiple logistic regression analysis for pure tone audiometry and operative findings to predict ossicular discontinuity was performed and a model for predicting ossicular discontinuity using logistic regression obtained. Results and Conclusion: Frequency-specific air bone gap (ABG) cut-off values can predict ossicular discontinuity in chronic suppurative otitis media namely: < 20 dB ABG at 500 Hz predicts absence of ossicular discontinuity while > 50 dB ABG at 500 Hz, >30 dB ABG at 2 KHz, and > 50 dB ABG at 4 KHz best predict the presence of ossicular discontinuity in general. In the absence of cholesteatoma, the air bone gaps of <30 dB at 500 Hz and <20 dB at 1 KHz decrease probability of ossicular discontinuity from 32.97% to 2.54%. Combination of air bone gaps of >50 dB at 500 Hz, >20 dB at 2 KHz and >40 dB at 4 KHz increase the probability of ossicular discontinuity from 32.97% to 85.9%. These findings suggest that ossicular exploration may not be necessary for the former while an evaluation of the ossicular chain may be mandatory for the latter in the setting where cholesteatoma is not present or suspected. Presence of cholesteatoma, granulation tissue and size of tympanic membrane perforation are important factors to consider in predicting ossicular discontinuity. Keywords: air bone gap; audiometry, pure tone; ossicular discontinuity; otitis media, suppurative; logistic reg

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A clinical study of evaluation of tympanoplasty with mastoidectomy in mucosal chronic otitis media

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20195709 ◽

2019 ◽

Vol 6 (1) ◽

pp. 163

Author(s):

Ritesh Mahajan ◽

Nidhi Abraham ◽

Nagaraj T. M.

Keyword(s):

Otitis Media ◽

Disease Process ◽

Chronic Otitis Media ◽

Chronic Suppurative Otitis Media ◽

Suppurative Otitis Media ◽

Medical College ◽

Cortical Mastoidectomy ◽

A Prospective Study

Background: Chronic suppurative otitis media (CSOM) is one of the most common ear diseases in developing countries with a varying incidence of 3% to 57%. It the disease process is further divided into mucosal type and squamosal type depending on clinical presentation. The mainstay of therapy in CSOM remains surgery which aims at eradication of disease and restoring the hearing mechanism. The main objective of our study was to evaluate the changes and impact of tympanoplasty with mastoidectomy as a surgical treatment modality in mucosal type of CSOM.Methods: A prospective study was conducted in Rajarajeshwari Medical College and Hospital between November 2015 and June 2017, involving 50 patients with mucosal type of chronic otitis media. These patients, after complete clinical examination and hearing analysis, underwent tympanoplasty with cortical mastoidectomy. Follow-up of the patients was done at one month and three months after the surgery where the parameters recorded preoperatively were assessed. Results: The graft uptake three months after the surgery was 94%. Patients reported a subjective improvement in symptoms of ear discharge, decreased hearing, earache and tinnitus to 94%, 70%, 86% and 78% respectively. There was hearing improvement in ears that had discharge preoperatively and those ears that did not.Conclusions: Chronic suppurative otitis media is a very common problem and it can lead to recurrent ear discharge and hearing problems. Timely intervention is necessary as early diagnosis results in good surgical outcomes and can make an impact on patient’s quality of life.

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