scholarly journals Tympanoplasty for Wet and Dry Perforation: A Prospective Comparative Study

2021 ◽  
Vol 28 (3) ◽  
pp. 260-265
Author(s):  
Amit Bikram Maiti ◽  
Rupam Sinha
Keyword(s):  
Prospective Study ◽  
Comparative Evaluation ◽  
Statistical Significance ◽  
Chronic Otitis Media ◽  
Tympanic Membrane Perforation ◽  
Hearing Improvement ◽  
Mucosal Disease ◽  
Membrane Perforation ◽  
Prospective Comparative Study ◽  
A Prospective Study

Introduction Two types of surgical procedures are performed for the treatment of Chronic otitis media (COM) mucosal disease, namely myringoplasty and tympanoplasty. In the present study, an objective, comparative evaluation between the outcomes of tympanoplasty, performed in the ‘wet ear’ and the ‘dry (non- discharging) ear’ has been undertaken. Materials and Methods A prospective study was conducted in a peripheral referral institute over a period of 37 months    wherein a total of 105 patients with tympanic membrane perforation were selected, amongst which 56 patients had moist ear and 49 patients had dry ear. All of the patients underwent tympanoplasty by underlay technique. Final results were analyzed 12 months post operatively. Results In the wet ear group amongst 56 patients, 51 patients had successful graft uptake (91.07%). In dry          ear group, among 49 patients, successful graft uptake was seen in 44 cases (89.79%). In the wet ear group 50 out of 56 patients had hearing improvement (89.28%). In dry ear group 44 out of 49 patients had hearing improvement (89.79%). Statistically significant results were obtained postoperatively in each group; however, inter group analyses showed no statistical significance. Conclusion Success rate of tympanoplasty does not depend upon the wet or dry state of middle ear at the time of surgery.

scholarly journals Effectiveness of transperforation myringoplasty in bilateral chronic otitis media patients undergoing contralateral tympanoplasty

2016 ◽  
Vol 131 (1) ◽  
pp. 64-68 ◽  
Author(s):  
A T Ihsan ◽  
K Ranjana
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Contralateral Side ◽  
Tympanic Membrane Perforation ◽  
Inclusion Criteria ◽  
Hearing Improvement ◽  
Membrane Perforation ◽  
Bilateral Surgery ◽  
A Prospective Study

AbstractObjectives:Bilateral tympanic membrane perforation closure is usually performed by otosurgeons in two sittings. However, in this study, transperforation myringoplasty was performed alongside contralateral tympanoplasty in a single sitting. The effectiveness of transperforation myringoplasty procedure and the benefits of single sitting bilateral surgery were evaluated.Methods:A prospective study of 50 selected patients with mucosal-type bilateral chronic otitis media was conducted. All patients underwent transperforation myringoplasty on the side that met the inclusion criteria and tympanoplasty on the contralateral side. Graft uptake and hearing improvement were evaluated after 6 months.Results:At the 6-month follow up, the graft uptake rate was 82 per cent, the hearing gain was 11.5 dB and the air–bone gap gain was 11.6 dB.Conclusion:This procedure offers perforation closure in a single sitting to patients with bilateral chronic otitis media who meet the inclusion criteria.

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 Comparative study of outcomes of type-1 tympanoplasty with and without anterior tucking

2020 ◽  
Vol 6 (4) ◽  
pp. 657
Author(s):  
Kiran Gangadar S. ◽  
G. Priyadarshini
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Chronic Otitis Media ◽  
Pure Tone Audiometry ◽  
Tympanic Membrane Perforation ◽  
Hearing Improvement ◽  
Type 1 Tympanoplasty ◽  
Membrane Perforation ◽  
Group 2

<p class="abstract"><strong>Background:</strong> Tympanoplasty is a surgical procedure for closing the tympanic membrane perforation and reconstructing the tympanic membrane and hearing, commonly after trauma and chronic otitis media. The aim of the study was to compare the clinical and audiological outcomes of tympanoplasty with or without anterior tucking.</p><p class="abstract"><strong>Methods:</strong> In this prospective study, 50 patients with chronic otitis media (COM) were divided into two groups. Group 1 underwent type 1 tympanoplasty with anterior tucking method, and group 2 underwent type 1 tympanoplasty without anterior tucking. The result was measured on graft uptake and hearing outcome at 6 months postoperatively by performing pure tone audiometry.  </p><p class="abstract"><strong>Results:</strong> The hearing improvement was almost the same in both the groups. Graft uptake was good in type 1 tympanoplasty with tucking (96%) when compared to without tucking tympanoplasty (92%). Complications like residual perforation were seen in both groups equally. Anterior marginal blunting was noted (8%) in type 1 tympanoplasty with tucking.</p><p class="abstract"><strong>Conclusions:</strong> The hearing improvement of type-1 tympanoplasty with anterior tucking and without anterior tucking is the same. Type-1 tympanoplasty with anterior tucking has a better graft acceptance. The only disadvantage of type-1 tympanoplasty with anterior tucking is anterior marginal blunting.</p>

scholarly journals Reinforced temporalis fascia with conchal cartilage versus exclusive temporalis fascia grafting in type 1 tympanoplasty: a comparative study

2020 ◽  
Vol 6 (7) ◽  
pp. 1268
Author(s):  
Rahul S. Gosavi ◽  
Shishir D. Gosavi ◽  
Digwijay A. Bandgar ◽  
Akash D. Gupta ◽  
Pradny S. Naik ◽  
...  
Keyword(s):  
Chronic Otitis Media ◽  
Tympanic Membrane Perforation ◽  
Temporalis Fascia ◽  
Conchal Cartilage ◽  
Type 1 Tympanoplasty ◽  
Fascia Graft ◽  
Membrane Perforation ◽  
A Prospective Study ◽  
Grafting Materials

<p class="abstract"><strong>Background:</strong> Various grafting materials have been used for the repair of a tympanic membrane perforation over the years, with temporalis fascia and conchal cartilage being the most widely used. Our study is an attempt to compare and analyse the use of exclusive temporalis fascia as grafting material against a reinforced graft consisting of temporalis fascia and conchal cartilage.</p><p class="abstract"><strong>Methods:</strong> This is a prospective study of 100 patients having inactive mucosal chronic otitis media with a dry central perforation with moderate conductive hearing loss, undergoing type 1 tympanoplasty using underlay technique. 50% of the subjects were grafted with temporalis fascia alone while a reinforced temporalis fascia graft along with conchal cartilage was used in the remaining 50% of the cases. The results were evaluated at an interval of 24 weeks after surgery on the basis of graft uptake and hearing restoration (closure of air-bone gap &lt;10 dB).  </p><p class="abstract"><strong>Results:</strong> Graft uptake in exclusive temporalis fascia grafting was 86% while it was 94% when a reinforced graft was used; the hearing restoration rates in both the groups were 82% and 80% respectively.   </p><p class="abstract"><strong>Conclusions:</strong> Reinforced temporalis fascia grafting along with conchal cartilage gives better results than grafting with temporalis fascia alone as regards to graft uptake, while the audiometric results are comparable in both the groups.   </p>

Endoscopic Type 1 Tympanoplasty in Chronic Otitis Media: Comparative Study with a Postauricular Microscopic Approach

2019 ◽  
Vol 161 (2) ◽  
pp. 315-323 ◽  
Author(s):  
Masafumi Ohki ◽  
Shigeru Kikuchi ◽  
Sunao Tanaka
Keyword(s):  
Success Rate ◽  
Otitis Media ◽  
Middle Ear ◽  
Chronic Otitis Media ◽  
Tympanic Membrane Perforation ◽  
Hearing Improvement ◽  
Surgical Time ◽  
Ear Surgery ◽  
Surgical Success ◽  
Membrane Perforation

ObjectiveTo compare surgical outcomes after tympanoplasty without ossiculoplasty for chronic otitis media between transcanal endoscopic ear surgery (TEES) and postauricular microscopic ear surgery (PAMES).Study DesignCase-control study.SettingTertiary care university hospital.Subjects and MethodsConsecutive patients ( N = 122) who had undergone tympanoplasty without ossiculoplasty for chronic otitis media were enrolled in this retrospective study and divided into 2 groups: TEES (n = 47) and PAMES (n = 75). Middle ear condition was graded with the middle ear risk index. Hearing, repair of tympanic membrane perforation, and surgical time were assessed.ResultsThe surgical success rate for hearing (air-bone gap ≤20 dB) was 95.7% in the TEES group and 84.0% in the PAMES group. Lower middle ear risk resulted in similar mean (95% CI) closure of air-bone gaps (TEES: 9.6, 6.5-12.6; PAMES: 8.0, 6.4-9.7; P = .333), whereas higher middle ear risk demonstrated significantly larger closure of air-bone gaps for the TEES group (10.1, 3.3-16.9) than the PAMES group (–0.2, –4.5 to 4.2; P = .009). The surgical success rate for repair of tympanic membrane perforation and surgical time were equivalent between TEES and PAMES.ConclusionUnder favorable conditions of the middle ear, TEES and PAMES resulted in similar hearing improvement by tympanoplasty without ossiculoplasty. However, under adverse conditions of the middle ear, TEES was a more beneficial approach for hearing improvement than PAMES.

scholarly journals Outcome of Interlay Type 1 Tympanoplasty for Large Central Perforation

2021 ◽  
Vol 27 (1) ◽  
pp. 86-91
Author(s):  
Md Mahmudul Huq ◽  
SM Mostofa Qaiyoum ◽  
Md Saifullah Ibne Mannan ◽  
Md Kamruzzaman
Keyword(s):  
Prospective Study ◽  
Uptake Rate ◽  
Chronic Otitis Media ◽  
Hearing Improvement ◽  
Effective Technique ◽  
Medical College ◽  
Type 1 Tympanoplasty ◽  
Central Perforation ◽  
A Prospective Study

Background: Perforation of the tympanic membrane may occur from various reasons. Most of these perforations heal spontaneously, whereas the remaining long-standing perforations that lead to recurrent ear discharge need tympanoplasty. Interlay Type 1 Tympanoplasty,a newer technique has shown promising results with higher success ratein terms of hearing gain and graft uptake. Objective: To analyze the results of interlay Type 1 Tympanoplasty in terms of graft uptake and hearing improvement in cases of inactive mucosal chronic otitis media (COM) with large central perforation. Methods: This is a prospective study of 24 months (January 2018 to December 2019) duration conducted in department of E.N.T, Khulna medical college, Khulna and data was collected from the 60 patients admitted for tympanoplasty. Results were calculated in terms of graft accepted or rejected and decrease in air bone gap. Result: The graft uptake rate in the present study was found to be 91.67% and the patients reported an improvement in terms of hearing. Pre operatively mean air bone gap was 26.5dBand post operatively after 12 weeks mean air bone gap improved to 17.58dB. Conclusion: Interlay Type 1 Tympanoplasty is an effective technique over conventional methods in terms of both graft uptake as well as hearing improvement in large central perforation. Bangladesh J Otorhinolaryngol; April 2021; 27(1): 86-91

An observational study of the management of traumatic tympanic membrane perforations

2002 ◽  
Vol 116 (3) ◽  
pp. 181-184 ◽  
Author(s):  
J. E. O. Amadasun
Keyword(s):  
Observational Study ◽  
Prospective Study ◽  
Tympanic Membrane ◽  
Tympanic Membrane Perforation ◽  
Control Group ◽  
Tympanic Membrane Perforations ◽  
Membrane Perforation ◽  
A Prospective Study

Controversies of how best to treat fresh tympanic membrane perforations have always existed. While some otolaryngologists prefer the paper patch method, others prefer modified myringoplasty. A prospective study is needed to investigate the most effective and least expensive management of this common ear trauma.This study examined prospectively, in three sections, a group of patients with a cellophane patch (n = 6), another group with a gentamicin ointment seal (n = 15) and a control group (n = 9) with a gentamicin plug placed at the distal end of the external auditory cavity. Successful healing of the traumatic tympanic membrane perforations was achieved in 50 per cent of the cellophane seal group, 86.7 per cent of the gentamicin ointment seal group and 77.8 per cent of the control group. This study shows that the management of a fresh tympanic membrane perforation should be limited to cleaning the traumatized ear and preventing infection.

scholarly journals Does Anterior Tunnelling Really Help in Underlay Type I Tympanoplasty?

2017 ◽  
Vol 25 (3) ◽  
pp. 142-147
Author(s):  
Sohag Kundu ◽  
Bhaskar Ghosh ◽  
Bijan Kumar Adhikary ◽  
Mainak Dutta
Keyword(s):  
Prospective Study ◽  
Tympanic Membrane Perforation ◽  
Type I ◽  
Hearing Result ◽  
Membrane Perforation ◽  
Type I Tympanoplasty ◽  
A Prospective Study ◽  
Hearing Outcomes ◽  
Statistical Comparability

Introduction Stabilizing the graft can be difficult with the conventional method of underlay tympanoplasty when the tympanic membrane perforation is subtotal, large or anteriorly placed with thin anterior rim. Tympanoplasty with anterior tunnelling has been tried to overcome this problem. Materials and Methods A prospective study over two-year period was carried out with follow up for three months on 59 patients under two groups- the underlay tympanoplasty with anterior tunnelling and the conventional tympanoplasty with anterior tucking for comparison in terms of pre-and post-operative anatomical correction and physiological improvements Results Follow up at 6 weeks and 12 weeks post operatively gives statistically comparable graft take up, hearing result and residual perforations. Discussion Among various techniques of dealing with these types of perforations, statistical comparability of the two groups brings in an acceptability to this simple but satisfying procedure of the underlay tympanoplasty with anterior tunnelling. Conclusion Underlay tympanoplasty technique (type-I) for subtotal, large or anteriorly placed perforations with thin anterior rim, can be managed by combining with anterior tunnelling which provides at least comparable results (if not more security against graft medialization) in respect of anatomical closure of perforations and hearing outcomes.

scholarly journals A multivariate analysis of chronic otitis related prognostic factors in determining hearing improvement in tympanoplasty

2013 ◽  
Vol 60 (4) ◽  
pp. 47-52
Author(s):  
Slobodan Spremo ◽  
Sanja Spiric ◽  
Dmitar Travar ◽  
Predrag Spiric ◽  
Mira Spremo
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Bone Erosion ◽  
Chronic Otitis Media ◽  
Ossicular Chain ◽  
Tympanic Membrane Perforation ◽  
Hearing Improvement ◽  
Membrane Perforation ◽  
Tube Function ◽  
Type Of Surgery

OBJECTIVE: The aim of this study was to evaluate which factors are best predictors of hearing improvement after tympanoplasty and to evaluate best functional outcome in different forms of pathology in the tympanic cavity and mastoid in chronic otitis media. METHODS: Prospective study included 120 patients who were operated for chronic suppurative otitis media and cholesteatoma in the ENT Department University Clinic Center Banja Luka from 2006 to 2011. Multiple linear regression analysis was used to measure which factors predict better hearing improvement. MAIN OUTCOME MEASURES: A model that evaluates factors related to chronic otitis media: ossicular chain integrity, tympanic tube function, tympanic membrane perforation, type of surgery and condition of tympanic and mastoid walls was used to predict postoperative hearing improvement. Hearing outcome was measured comparing preoperative to postoperative pure-tone average (PTA) and postoperative air-bone gap (ABG). RESULTS: Out of 120 operated patients, we performed primary surgery in 106 and revision surgery in 9 cases due to recurrent cholesteatoma. We observed high correlation and statistically significant contribution of ossicular chain pathology (b=-0.310, t=-3.01, p<0.05), and mastoid bone erosion or defects (b=2.05, t=2.05 , p<0.05), on the variance of PTA. The same variables were highly correlated with ABG closure: ossicular chain pathology (b=-0.230, t=-2.14, p<0.05), and mastoid bone erosion or defects (b= 2.05, t=2.08 , P<0.05). Variance of preoperative to postoperative PTA difference explained by the model as a whole was 24,7%, F(8,119)=4.54 , p<0.01. Variance of preoperative to postoperative ABG difference explained by the model as a whole was 18,3% F(8,119)=3.1, p<0.01. The predictive model in this study included 8 variables related to middle ear pathology proved to be superior to analyzing each variable separately. CONCLUSION: A model that evaluates factors related to chronic otitis media: ossicular chain integrity, tympanic tube function, tympanic membrane perforation, type of surgery and condition of tympanic and mastoid walls has significant predictive value for hearing assessment in tympanoplasty.

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