Temporalis fascia graft versus composite graft in chronic suppurative otitis media with subtotal and total perforations

2018 ◽  
Vol 24 (1) ◽  
pp. 23
Author(s):  
ManasRanjan Rout ◽  
Deeganta Mohanty ◽  
ChintaguntaPakeer Das ◽  
PVittal Prasad
Keyword(s):  
Otitis Media ◽  
Composite Graft ◽  
Chronic Suppurative Otitis Media ◽  
Temporalis Fascia ◽  
Suppurative Otitis Media ◽  
Fascia Graft

scholarly journals Comparative study between result of temporalis muscle fascia and tragal cartilage perichondrium as a graft material in type 1 tympanoplasty

2018 ◽  
Vol 4 (2) ◽  
pp. 565
Author(s):  
Abhay Kumar ◽  
Prabhu Narayan ◽  
Prem Narain ◽  
Jaypal Singh ◽  
Prateek Kumar Porwal ◽  
...  
Keyword(s):  
Otitis Media ◽  
Pure Tone Audiometry ◽  
Chronic Suppurative Otitis Media ◽  
Graft Material ◽  
Temporalis Fascia ◽  
Suppurative Otitis Media ◽  
Hearing Results ◽  
Group Type ◽  
Type 1 Tympanoplasty

<p class="abstract"><strong>Background:</strong> Leading cause of deafness in India is chronic suppurative otitis media. Most common cause of TM perforation is chronic suppurative otitis media. With this background this study was to compare hearing results, as well as graft takes for commonly preferred reconstruction techniques of the TM (i.e., temporalis fascia vs. cartilage) in tympanoplasty.</p><p class="abstract"><strong>Methods:</strong> The present study consists of 60 cases of C.S.O.M (TTD) which was divided into two groups with 30 cases in each group. In first group type1 tympanoplasty was done by Temporalis fascia technique. In second group type 1 tympanoplasty done by tragal cartilage with perichondrium technique. History and otoscopic examination along with pure tone audiometry was performed preoperatively. Postoperative hearing results and graft uptake were compared between two groups, all surgeries were performed through the post aural approach.  </p><p class="abstract"><strong>Results:</strong> Graft uptake results are better with tragal cartilage with perichondrium technique. Hearing improved significantly in both groups. Though this was slightly better in TFT, but not significant statistically.</p><p><strong>Conclusions:</strong> Graft uptake rates are better with the tragal cartilage with perichondrium technique in comparison of TFT and hearing results are almost equivalent with both techniques.</p>

scholarly journals Comparative study of graft materials used in myringoplasty

2019 ◽  
Vol 5 (3) ◽  
pp. 549
Author(s):  
Anchal Gupta ◽  
Apurab Gupta ◽  
Padam Singh Jamwal
Keyword(s):  
Comparative Study ◽  
Otitis Media ◽  
Chronic Otitis Media ◽  
Hearing Improvement ◽  
Temporalis Fascia ◽  
Suppurative Otitis Media ◽  
Central Perforation ◽  
Fascia Graft ◽  
Group 2 ◽  
Group 1

<p class="abstract"><strong>Background:</strong> Various graft materials are used for myringoplasty in practice. Present study was done to compare the hearing improvement and graft uptake rate in patients with inactive mucosal type chronic otitis media with central perforation undergoing myringoplasty using either of the two graft materials: temporalis fascia and conchal perichondrium.</p><p class="abstract"><strong>Methods:</strong> Patients with tubotympanic type of chronic suppurative otitis media were selected from patients attending the ENT OPD of SMGS Hospital, Government Medical College, Jammu between July 2016 to March 2018. This study included 100 patients out of which 50 were subjected to myringoplasty with temporalis fascia grafting (Group 1) and remaining 50 to conchal perichondrium grafting (Group 2) using underlay technique. The comparative study was done on following parameters-graft uptake and audiological outcome.  </p><p class="abstract"><strong>Results:</strong> 82% patients were of age less than 30 years. The overall male: female ratio was 1.3:1. In Group 1, 76% had gain of 15 db while 12% had gain of &gt;15 db. In Group 2, 72% had gain of 15 db and 8% had gain of &gt;15 db. The graft was intact in 84% patients. 12% of Group 1 patients, showed residual perforation whereas it was 20% in Group 2 patients.</p><p class="abstract"><strong>Conclusions:</strong> The study showed that: the temporalis fascia graft is better than conchal perichondrial graft for closure of perforations in inactive mucosal type of chronic otitis media with central perforation because of maximum hearing improvement and minimal failure rate in group receiving temporalis fascia graft.</p>

scholarly journals Comparative evaluation of surgical and audiological outcomes in patients of chronic suppurative otitis media with dry ear treated by myringoplasty with or without simple mastoidectomy

2017 ◽  
Vol 3 (4) ◽  
pp. 1052
Author(s):  
Amanjot Kaur ◽  
Vinod M.K. ◽  
Jagdeepak Singh ◽  
Baldev Singh ◽  
Priyanka . ◽  
...  
Keyword(s):  
Otitis Media ◽  
Statistical Significance ◽  
Chronic Suppurative Otitis Media ◽  
Mastoid Process ◽  
Open Label ◽  
Suppurative Otitis Media ◽  
Medical College ◽  
Fascia Graft ◽  
Before And After ◽  
Group B

<p class="abstract"><strong>Background:</strong> The study was conducted to compare and evaluate surgical and audiological outcomes in patients of chronic suppurative otitis media with dry ear treated by myringoplasty with or without simple mastoidectomy. Prospective, open label, randomized, comparative  study, conducted  in the Department of ENT, Ram Lal Eye and ENT hospital, Government Medical College Amritsar, Punjab, India.</p><p class="abstract"><strong>Methods:</strong> This study comprised of 40 patients aged between 15 to 50 years having CSOM (safe type) with dry ears for the last 3 months. Patients were randomly divided into Group A<strong> </strong>treated with<strong> </strong>myringoplasty alone and Group B with standard simple mastoidectomy along with<strong> </strong>myringoplasty using temporalis fascia graft by underlay technique. Patients also subjected to routine hematological, biochemical, radiological and audiological investigation. The audiological comparison done before and after surgery.  </p><p class="abstract"><strong>Results:</strong> It was observed that graft uptake rate was better in group B. The average gain in air conduction threshold was more in patients who had undergone myringoplasty along with simple mastoidectomy. However this was not statistically significant. There was no significant improvement observed in the AB Gap in our patients who underwent myringoplasty or simple mastoidectomy along with myringoplasty.</p><p class="abstract"><strong>Conclusions:</strong> Hypocellularity of the mastoid process has a strong correlation with the tubotympanic type of CSOM. Addition of mastoidectomy to simple myringoplasty has a very little beneficial effect on the postoperative hearing gain and graft uptake as it showed no much statistical significance.</p>

scholarly journals Myringoplasty using temporalis fascia and its clinical outcome

2019 ◽  
Vol 5 (6) ◽  
pp. 1539 ◽  
Author(s):  
Akbar Zaman ◽  
Saif Omar
Keyword(s):  
Hearing Loss ◽  
Success Rate ◽  
Otitis Media ◽  
Tympanic Membrane Perforation ◽  
Chronic Suppurative Otitis Media ◽  
Temporalis Fascia ◽  
Suppurative Otitis Media ◽  
Before And After ◽  
Membrane Perforation ◽  
Middle Ear Cleft

<p class="abstract"><strong>Background:</strong> Chronic suppurative otitis media is one of the common otological conditions in India for which patients seek advice from an otorhinolaryngologist. Various surgical modalities of treatment have been tried since ages, to eliminate the disease from middle ear cleft, with varying degrees of success rate. One such modality of treatment is myringoplasty. The aim of the present study was to assess the success rate of myringoplasty using temporalis fascia and to evaluate preoperative and postoperative hearing loss in patients with chronic suppurative otitis media.</p><p class="abstract"><strong>Methods:</strong> Sixty adult cases of tympanic membrane perforation were included in the study. Myringoplasty was performed in all cases and hearing loss was compared both before and after surgery.  </p><p class="abstract"><strong>Results:</strong> Preoperatively 20 cases showed hearing loss at 16-25 dB, 26 cases at 26-40 dB, and 14 cases showed hearing loss at &gt;40 dB. Graft uptake was successful in 50 patients (83.33%). Postoperatively definitive improvement of hearing was observed in 46 patients. The success rate of surgery in cases of dry ear with more than 6 months was 100%.</p><p class="abstract"><strong>Conclusions:</strong> Outcome of myringoplasty does not depend on sex and site of perforation. Dry ear of duration greater than 6 months is a favourable prerequisite. Graft take up was impaired in cases of sclerotic mastoid and postoperative infection.</p>

scholarly journals Retrospective Study of Clinical Profile of Patients with Chronic Suppurative Otitis Media at a Tertiary Health Centre

2014 ◽  
Vol 1 (1) ◽  
pp. 7 ◽  
Author(s):  
Shreeya Kulkarni ◽  
Kiran S. Burse ◽  
Devashri Patil ◽  
Chaitanya Bharadwaj ◽  
Vandana Sancheti ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Otitis Media ◽  
Health Centre ◽  
Chronic Suppurative Otitis Media ◽  
Graft Material ◽  
Age Group ◽  
Temporalis Fascia ◽  
Suppurative Otitis Media ◽  
Nerve Paralysis ◽  
Mastoid Surgery

<strong>Introduction:</strong> Chronic Suppurative Otitis Media (CSOM) is frequently associated with symptoms of inflammation like discharge from the ear or pain. In many cases, patients suffer from hearing loss causing communication problems and social withdrawal. Tubotympanic type of chronic suppurative otitis media is characterized by a perforation of pars tensa, while marginal &amp; attic perforations are pathognomonic of attico-antral variety. The latter category is usually associated with the presence of cholesteatoma. In cases of cholesteatoma, complications like facial nerve paralysis, meningitis, cerebellar abscess, sigmoid sinus thrombosis may develop and potentially threaten the patient's life. The aim of this study was to retrospectively perform analysis of patients suffering from Chronic Suppurative Otitis Media, visiting our Tertiary Health Centre, Nashik. <strong>Materials and Methods:</strong> This was a retrospective study, conducted in a tertiary care medical college hospital over a period of 5 years. The study group comprised 528 patients in and around Nashik District and were subjected to Tympanoplasty or Mastoid surgery. <strong>Results:</strong> Complete data records from 528 patients were available for statistical analysis. Maximum numbers of patients were in age group 21-40. High prevalence of CSOM was found in females. 408 patients had CSOM of Safe type. 97 patients had CSOM of unsafe type, whereas 23 patients had unsafe CSOM with complications. 381 patients underwent Type 1 Tympanoplasty, while 31 patients underwent Modified Radical Mastoid Surgery. 61 patients were operated for MRM with Tympanoplasty and 28 patients were operated for MRM with Myringostapediopexy. 27 patients were operated for revision tympanoplasty. Different methods of tympanoplasty were performed. Simple underlay was done in 123 patients. Maximum patients about 245 were operated by cartilage support method of tympanoplasty. Anterior tucking was done in 40 patients. Myringostapediopexy was done in 28 patients. Ossiculoplasty with tragal or conchal cartilage was done in 61 patients. Graft was not placed in 31 patients. Temporalis fascia was used in maximum patients. In 90.9% of patients temporalis fascia was used. Fascia Lata was used in 3.2% of patients. <strong>Conclusion:</strong> Retrospective study of patients with CSOM shows: females were affected more than males. Majority of patients were in age group of 21 to 40 years. The reason could be that this age group is socially active and health conscious. 77.3% of patients had safe CSOM while 22.7% of patients had unsafe CSOM. 2.27% of patients had extra-cranial complication, and 2.08% of patients had intracranial complications. 5.1% of patients underwent revision tympanoplasty surgery. Temporal is fascia as a graft material was used for tympanoplasty in maximum patients, and cartilage support method of tympanoplasty was used in majority of patients. Maximum patients were operated in year 2012. This was due to conduction of camps in peripheral areas around Nashik City which shows that CSOM is more common in patients of lower socioeconomic group, overcrowding, sub-standard hygiene and under resourced health care.

Mastoid surgery at the Red Cross War Memorial Children's Hospital 1986–1988

1991 ◽  
Vol 105 (6) ◽  
pp. 409-412 ◽  
Author(s):  
C. A. J. Prescott ◽  
J. F. Malan
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Chronic Suppurative Otitis Media ◽  
Red Cross ◽  
Temporalis Fascia ◽  
Acute Mastoiditis ◽  
Pars Flaccida ◽  
Suppurative Otitis Media ◽  
One Year ◽  
Mastoid Surgery

AbstractEighty-three children between ages 0–12 years had mastoid surgery in the three year period 1986–88. The indications were acute mastoiditis (30 children), uncontrolled chronic suppurative otitis media (CSOM) (24 children), cholesteatoma (22 children) and a miscellaneous group (7 children). Forty-seven per cent of those with acute mastoiditis were under one year but the 27 per cent with cholesteatoma as the precipitating cause were 4–12 years. Twenty-three per cent had significant complications. Typmano-mastoid surgery was employed to resolve uncontrolled CSOM. Children were between 2–12 years and 62 per cent were below the 25th centile for weight. Seventy-nine per cent of the tympanic membrane grafts were successful. The children with cholesteatoma were between 3–12 years and 76 per cent were below the 25th centile for weight. Eight of them only presented after the onset of acute mastoiditis. One child had a definite congenital cholesteatoma. Only one had a pars flaccida origin of the cholesteatoma sac and only eight an origin from the postero-superior pars tensa. All had open cavity surgery. When the cavity was lined by temporalis fascia, healing was improved markedly.

Tympano–cartilago–stapediopexy: a method to improve hearing in open technique tympanoplasty

1990 ◽  
Vol 104 (12) ◽  
pp. 942-944 ◽  
Author(s):  
H. M. Moustafa ◽  
M. A. Khalifa
Keyword(s):  
Otitis Media ◽  
The Other ◽  
Chronic Suppurative Otitis Media ◽  
Canal Wall ◽  
Open Technique ◽  
Temporalis Fascia ◽  
Suppurative Otitis Media ◽  
Type Iii ◽  
Canal Wall Down

AbstractCanal wall-down technique tympanoplasty was indicated in about 41 per cent of our cases with chronic suppurative otitis media. In this series done during the last four years, of 576 tympanoplasties, 240 cases needed type III tympanoplasty. In 145 cases, myringostapediopexy was carried out using temporalis fascia grafting over the head of the stapes. Tympano-cartilago-stapediopexy was performed in the other 95 cases by using tragal cartilage and perichondrium over the stapes. A comparison between the results of both methods of grafting is discussed. Improvement in hearing was achieved after tympano-cartilago-stapediopexy. This method proved to be suitable for those cases which need open technique tympanoplasty.

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

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 

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