Features of combined endoscopic tympanoplasty in children with chronic otitis media with cholesteatoma

Topicality: Chronic purulent otitis media is a disease that is often encountered in everyday practice by otolaryngologists. To date, the full rehabilitation of the middle ear in pediatric practice has caused much debate about the method of surgery and remains a difficult surgical task. Aim: to develop a more effective combined method of endoscopic microsurgery in children with chronic otitis media with cholesteatoma. Materials and methods: examined 52 children aged from 2 to 12 years, operated on a closed variant of tympanoplasty for cholesteatoma otitis. Patients were divided into 2 groups: 1st group (comparison), which used the standard technique of closed variant of surgery with retroauricular incision using an operating microscope (33 patients); and the 2nd group (main), where the combined surgery with retroauricular incision with the using of a microscope and endoscope and endoaural drainage of the antrum was performed in 19 patients. Results: We conducted an analysis of different types of tympanoplasty in a closed variant of tympanoplasty in children with cholesteatoma otitis and endoaural drainage of the antrum or without it. In the main group, the number of secondary engraftment of the neotympanic membrane decreased 3.4 times, residual perforations – 2.9 times, residual cholesteatoma – 2.9 times, the number of repeated operations – 3.5 times relative to the comparison group. Conclusion: At the combined surgery of cholesteatoma otitis with endoscopic support at patients of the main group the percent of residual cholesteatoma is lower. The endoaural drainage of the antrum provides additional ventilation and drainage of the reconstructed cavities of a middle ear in the early postoperative period, increases the number of primary engraftment of the neotympanic membrane and reduces the percentage of residual perforations.

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Correlation Between MERI and Hearing After Tympanoplasty

Journal of Nepalgunj Medical College ◽

10.3126/jngmc.v13i2.16533 ◽

2017 ◽

Vol 13 (2) ◽

pp. 6-9 ◽

Cited By ~ 1

Author(s):

Anshu Sharma ◽

R. K. Saxena ◽

Lok Ram Verma ◽

Shama Bhandari

Keyword(s):

Otitis Media ◽

Middle Ear ◽

Analytical Study ◽

Risk Index ◽

Chronic Otitis Media ◽

Hearing Improvement ◽

Hearing Gain ◽

Different Types ◽

The Mean ◽

The Impact

Background: Chronic otitis media is otological challenge in the developing countries it is particularly single most common cause of hearing impairement.Objective: The objective of this study was to observe the impact of prognostic factor middle ear risk index on hearing of patients undergoing tympanoplasty for chronic otitis media.Methods: This was a prospective analytical study conducted in 50 patients planned for tympanoplasty for chronic otitis media and evaluation done by MERI (Middle Ear Risk Index) and pure tone audiometry.Results: This study shows that most of the patients had mild MERI (64%), followed by severe MERI (20%) and then moderate MERI (16%). The mean preoperative PTA average was 44.34 dB (SD 8.01 dB) for patient with mild MERI, 44.75 dB (SD 5.87 dB) for patient with moderate MERI, and 54.9 dB (SD 14.05 dB) for patient with severe MERI and the mean preoperative A-B gap was 37.36 dB (SD 5.73 dB). Post operatively for mild MERI mean hearing gain is 12-14dB, for moderate MERI mean hearing gain is 10-13dB and for severe MERI mean hearing gain is 10-13dB and post operative mean A-B gap was improved by 10-11dB. There is a statistically significant hearing improvement in A-B gap with different types of MERI.Conclusion: MERI scoring is useful for predicating the outcome of hearing after tympanoplasty.JNGMC Vol. 13 No. 2 December 2015, Page: 6-9

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Comparison of the Aditus ad Antrum Diameter on CT between Patients with Chronic Otitis Media and Healthy Individuals

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405615666190327110216 ◽

2019 ◽

Vol 15 (10) ◽

pp. 990-993 ◽

Cited By ~ 1

Author(s):

Elif Gündoğdu ◽

Uğur Toprak

Keyword(s):

Computed Tomography ◽

Otitis Media ◽

Middle Ear ◽

Healthy Subjects ◽

Normal Values ◽

Chronic Otitis Media ◽

Healthy Individuals ◽

Inner Diameter ◽

Male Patients ◽

The Right

Background: The middle ear cavity is ventilated through the aditus ad antrum. Aditus blockage contributes to the pathology of otitis media. Objective: To determine the normal values of the aditus ad antrum diameter on computed tomography and to investigate its relationship with chronic otitis media and related pathologies (tympanosclerosis and myringosclerosis). Methods: The temporal CT images of 162 individuals were evaluated retrospectively. In the axial sections, the inner diameter of the aditus was measured at the narrowest point at the cortex. The differences in diameter were compared between diseased and healthy ears. Results: In healthy individuals, the diameter was narrower in women. There was no difference between the right and left ears in healthy subjects. No correlation was found between age and diameter. In male patients with myringosclerosis, the diameter was slightly narrower on both sides but more marked on the left. In female patients with myringosclerosis, the diameter in both ears was slightly narrower. In cases of otitis media and tympanosclerosis, the diameter was less than that of healthy individuals, despite the lack of statistically significant result in all cases. Conclusion: The aditus ad antrum was narrower in diseased ears, indicating that a blocked aditus may contribute to the development of otitis media, as well as mucosal diseases.

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Tissue Concentrations of Enoxacin in the Middle Ear of Patients with Chronic Otitis Media.

Practica Oto-Rhino-Laryngologica ◽

10.5631/jibirin.85.131 ◽

1992 ◽

Vol 85 (1) ◽

pp. 131-135

Author(s):

Nozomu Mori ◽

Akio Shugyo ◽

Hiroshi Furuta ◽

Yasuki Watanabe ◽

Takafumi Kawahara ◽

...

Keyword(s):

Otitis Media ◽

Middle Ear ◽

Chronic Otitis Media ◽

Tissue Concentrations

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Medical tactics in chronic otitis media

Kazan medical journal ◽

10.17816/kazmj80091 ◽

1995 ◽

Vol 76 (1) ◽

pp. 23-25

Author(s):

R. M. Nursaitova ◽

O. A. Guryanov

Keyword(s):

Otitis Media ◽

Middle Ear ◽

Chronic Otitis Media ◽

Potential Danger

It is advisable to perform cautious radical operations at the same time with plasty elements. The early surgicai sanation of the middle ear is recommended allowing to preserve its elements, to increase the possibilities of reconstruction and consequently, to decrease a potential danger for acoustic function of a patient as well as for his life as a whole.

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Clinical analysis on surgery of middle ear cholesteatoma and chronic otitis media

The Journal of Laryngology & Otology ◽

10.1017/s0022215116006678 ◽

2016 ◽

Vol 130 (S3) ◽

pp. S221-S221

Author(s):

Ayiheng Qukuerhan ◽

Nilipaer Alimu ◽

Halimulati Muertiza ◽

Pilidong Kuyaxi

Keyword(s):

Otitis Media ◽

Middle Ear ◽

Chronic Otitis Media ◽

Clinical Analysis ◽

Middle Ear Cholesteatoma

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Determining Otitis Media Severity from Middle Ear Fluid Analysis

Annals of Otology Rhinology & Laryngology ◽

10.1177/00034894941030s512 ◽

1994 ◽

Vol 103 (5_suppl) ◽

pp. 43-45 ◽

Cited By ~ 30

Author(s):

Steven K. Juhn ◽

William J. Garvis ◽

Chap T. Le ◽

Chris J. Lees ◽

C. S. Kim

Keyword(s):

Otitis Media ◽

Middle Ear ◽

Otitis Media With Effusion ◽

Chronic Otitis Media ◽

Complex Nature ◽

Fluid Analysis ◽

Factor Α ◽

Necrosis Factor ◽

Ear Effusion ◽

Chemical Mediators

Otitis media has a complex multifactorial pathogenesis, and the middle ear inflammatory response is typified by the accumulation of cellular and chemical mediators in middle ear effusion. However, specific biochemical and immunochemical factors that may be responsible for the severity or chronicity of otitis media have not been identified. Identification of factors involved in chronicity appears to be an essential step in the treatment and ultimate prevention of chronic otitis media. We analyzed 70 effusion samples from patients 1 to 10 years of age who had chronic otitis media with effusion for two cytokines (interleukrn-1β and tumor necrosis factor α) and total collagenase. The highest concentrations of all three inflammatory mediators were found in purulent otitis media, and concentrations were higher in younger than in older patients. Mediator concentrations were similar in samples obtained from patients having their first myringotomy for otitis media with effusion and in those who had had multiple previous myringotomies. The multiresponse star, which incorporates several biochemical parameters in one graphic illustration, may best characterize the complex nature of middle ear inflammation.

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Impact of depressive disorders on quality of life after middle ear surgery in patients with chronic otitis media

European Archives of Oto-Rhino-Laryngology ◽

10.1007/s00405-020-06397-7 ◽

2020 ◽

Author(s):

Susen Lailach ◽

Theresa Langanke ◽

Thomas Zahnert ◽

Susan Garthus-Niegel ◽

Marcus Neudert

Keyword(s):

Quality Of Life ◽

Depressive Symptoms ◽

Otitis Media ◽

Middle Ear ◽

Short Form ◽

Chronic Otitis Media ◽

Middle Ear Surgery ◽

Ear Surgery ◽

Sf 36

Abstract Purpose The aim of this study was to determine whether preoperative depressive symptoms influence health-related quality of life (HRQOL) after middle ear surgery in patients with chronic otitis media (COM). Methods This prospective clinical case study was conducted at a tertiary referral center. All 102 patients who had undergone middle ear surgery for COM were assessed clinically and by audiometric testing (pure tone audiometry) in pre- and postoperative settings. Disease-specific HRQOL was assessed by the validated chronic otitis media outcome test 15 (COMOT-15) and the Zurich chronic middle ear inventory (ZCMEI-21). General HRQOL was measured using the short form 36 (SF-36). Depressive symptoms were assessed using the patient health questionnaire (PHQ-D). The Charlson comorbidity index (CCI) was used to classify comorbidities. The middle ear status was determined using the ossiculoplasty outcome parameter staging (OOPS) index. Results After middle ear surgery, the total COMOT-15 and ZCMEI-21 scores improved significantly (p < 0.001). General HRQOL (total SF-36 score) was unaffected by surgery (p < 0.05). Patients without elevated depressive symptoms had significantly better total scores for the COMOT-15 (p < 0.01), ZCMEI-21 (p < 0.001), and for SF-36 (p < 0.001) postoperatively. The results of the multiple regression analyses show that, after adjusting for the OOPS, CCI, and hearing improvement, preoperative depressiveness was significantly associated with worse postoperative COMOT-15 and ZCMEI-21 outcome scores (β = 0.425 and β = 0.362, p < 0.001). Conclusion Preoperative depressiveness was an essential predictive factor for HRQOL in patients with COM. This should be considered during patient selection to provide more suitable preoperative counseling.

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Comparative study between throat swab and ear discharge swabs culture and sensitivity findings in pediatric patients with bilateral chronic otitis media

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20192707 ◽

2019 ◽

Vol 5 (4) ◽

pp. 932

Author(s):

Sudhakar Rao M. S. ◽

Navneeth T. P.

Keyword(s):

Otitis Media ◽

Eustachian Tube ◽

Middle Ear ◽

Throat Swab ◽

Chronic Otitis Media ◽

Age Group ◽

Pediatric Age ◽

Pediatric Age Group ◽

The Common ◽

Culture And Sensitivity

Background: Chronic otitis media is one of the common infections seen in pediatric age group. The most widely recognized route of infection is via the eustachian tube. The inflammation of the pharyngeal end of the eustachian tube may prevent gas exchange, leading to lowering of the middle ear pressure and predisposes to aspiration of nasopharyngeal microbes into the middle ear cleft.Methods: Eighty (80) cases of clinically diagnosed chronic otitis media among pediatric age group of both sexes selected on simple random basis were included in this study. Swabs from both ears and throat were taken and the samples were sent under strict aseptic conditions for culture and sensitivity testing. Results: The mean age of patients was 6.1years and the frequency of chronic otitis media was maximum in 1-5 years age group. Male to female ratio was 1.6:1.The most frequent organism isolated was S. Aureus followed by Psuedomonas. The ear swab and throat swab findings showed positive relationship (p<0.05) for the common organisms i.e., S. Aureus, pseudomonas and Streptococcus pyogenes respectively, thus suggesting a common etiological agent. Psuedomonal infection was found to be associated with large perforation in tympanic membrane.Conclusions: The pathology in bilateral ear disease is central i.e., throat. Treatment in these cases is focused on selected drug with optimum dose and calculated regimen of treatment completely, thus reducing the morbidity of loss of physiological function of the ear and the grave complications involved.

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