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

2021 ◽  
Vol 8 (7) ◽  
pp. 136-141
Author(s):  
Sumit Sharma ◽  
Chhavi Gupta ◽  
Richa Singh
Keyword(s):  
Otitis Media ◽  
Chronic Suppurative Otitis Media ◽  
Hearing Improvement ◽  
Suppurative Otitis Media ◽  
Type 1 Tympanoplasty ◽  
Cortical Mastoidectomy ◽  
Significant Difference ◽  
Group A ◽  
Group B

This is a comparative study done to evaluate outcome of type 1 Tympanoplasty with and without mastoidectomy in terms of hearing improvement and graft uptake. This is a prospective study done in 100 patients at a tertiary care referral centre during November 2018 to march 2020. Patients were divided in two groups, Group A consists of 50 patients in whom type 1 Tympanoplasty was done and in Group B 50 patients were there who had undergone Type 1 Tympanoplasty with cortical mastoidectomy. Patients were evaluated postoperatively at 2nd wk, 4th wk, 2nd month and 3rd month for graft uptake, disease clearance, and hearing improvement. PTA was done at 3rd month postoperatively. In our study we observed graft uptake in 94% of patients in Group A as compared to 98% of patients in Group B and in terms of hearing improvement there is not much difference in both the groups i.e. in Group A it is 13.996 ± 4.235 while in Group B it is 14.172 ± 5.381 P value is 1 which means there is no statistically significant difference in two groups. Though better results were observed for cortical mastoidectomy with Type 1 Tympanoplasty than Type 1 Tympanoplasty alone but the difference was insignificant. Keywords: Cortical Mastoidectomy; Mucosal Chronic Suppurative Otitis Media; CSOM.

scholarly journals Outcome of ear surgeries in dry and wet ear

2017 ◽  
Vol 3 (3) ◽  
pp. 562 ◽  
Author(s):  
Shreyash C. S. ◽  
Rajneesh . ◽  
Rahul S.
Keyword(s):  
Success Rate ◽  
Otitis Media ◽  
Chronic Otitis Media ◽  
Success Rates ◽  
Hearing Improvement ◽  
Suppurative Otitis Media ◽  
Time Of Surgery ◽  
Type 1 Tympanoplasty ◽  
Cortical Mastoidectomy

<p class="abstract"><strong>Background:</strong> Chronic suppurative otitis media (CSOM) can present with dry and wet ear (discharging ear). It’s an accepted fact that an actively draining central perforation is not a contraindication for ear surgery. The discharging ear presents the otologists with the dilemma of operating on it or not, this is due to widespread belief that the success rate while doing ear surgeries on wet ears is decidedly inferior. Hence the present dissertation is intended to find the outcome of ear surgeries in dry and wet ear.</p><p class="abstract"><strong>Methods:</strong> The present study comprises of 60 patients who have undergone type 1 tympanoplasty with cortical mastoidectomy, at Fr Muller’s Medical College, Mangalore. These patients were divided into two groups- Wet and Dry, based on the presence or absence of ear discharge at the time of surgery respectively. Inclusion Criteria: Patients of age group 16-60 years and both sexes, with mucosal type of chronic otitis media who underwent type 1 tympanoplasty with cortical mastoidectomy. Exclusion criteria: Patients with squamosal type of chronic otitis media or with ossicular chain erosion. A comparative analysis was done on the hearing improvement and incidence of the graft uptake postoperatively between the two groups.</p><p class="abstract"><strong>Results:</strong> In dry group, complete graft uptake was seen in 90% cases, whereas in wet group, a graft uptake rate of 86.7% was achieved. The graft take up rate is better in high x socio-economic status. Higher take up rates were seen in small and medium perforation compared to subtotal perforations. Hearing improvement, assessed by mean gain of PTA at the end of 6th month postoperatively, was achieved in 86% cases in Wet group and 90% cases in Dry group. There was an average hearing improvement of 13.08 db in speech frequencies in 88.3% cases. The difference between the two groups was statistically insignificant.</p><p><strong>Conclusions:</strong> In our study, we found no statistically significant differences between the success rates of Wet and Dry group, either in terms of graft uptake or the hearing improvement. Thus, from our study, we conclude that the presence of ear discharge at the time of surgery does not affect the success rate of type 1 tympanoplasty. </p>

scholarly journals To assess the hearing improvement in patients of Chronic Otitis Media Tubotympanic type post tympanoplasty

2020 ◽  
Vol 6 (6) ◽  
pp. 305-308
Author(s):  
Harsh Lokhna ◽  
◽  
Sanjay Kumar ◽  
Anshul Bansal ◽  
◽  
...  
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Hearing Improvement ◽  
Middle Ear Mucosa ◽  
Suppurative Otitis Media ◽  
Type 1 Tympanoplasty ◽  
Significant Difference

Aim: To determine hearing improvement in type- 1 tympanoplasty by comparing mean preoperative air bone gap with mean postoperative AB gap. Material and method: Patients clinically diagnosed as 75 cases of Chronic Suppurative Otitis Media Tubotympanic Type Disease presenting to the ENT OPD of Chhatrapati Shivaji Hospital attached to Subharti Medical College, Meerut were taken up for study. Detailed clinical examination and history was taken. Pure tone audiometry was conducted, hearing loss and mean AB Gap was noted pre-operatively. X-Ray mastoid B/L Schuller’s view was done and findings were noted. Tympanoplasty type 1 with or without mastoidectomy was performed. Cortical mastoidectomy with type 1 Tympanoplasty was performed in patients having granulations & polypoidal middle ear mucosa along with sclerotic mastoid. All these patients were followed up post-operatively at 6 weeks. The status of graft uptake was noted. Pure tone audiometry was performed. Hearing loss and mean AB Gap results were compared with pre-operative findings. Results: In our study out of 75 patients, 33 (44%) patients were affected with Right ear and 42 (56%) patients were affected with Left ear. Hearing loss was the chief complaint in all 75 patients (100%) followed by blocking sensation. Post operatively 58 (77.33%) patients had normal hearing followed by 16 (21.33) patients who had mild hearing loss. Only 1 (1.33%) patient had moderately severe hearing loss. Pre-operatively, mean AB Gap was 46.62+/-7.89dB while post-operatively mean AB Gap was 23.43+/-5.52dB with statistically significant difference as p<0.05. Conclusion: In our study, the post-operative Mean AB Gap was improved significantly as compared to preoperative mean AB Gap.

scholarly journals Assessment of the outcome of myringoplasty with cortical mastoidectomy in dry and wet mucosal type of chronic otitis media

2020 ◽  
Vol 6 (11) ◽  
pp. 2001
Author(s):  
Sreeshma Balan ◽  
Prakash M. D.
Keyword(s):  
Success Rate ◽  
Otitis Media ◽  
Statistical Significance ◽  
Chronic Otitis Media ◽  
P Value ◽  
Hearing Improvement ◽  
Cortical Mastoidectomy ◽  
Significant Difference ◽  
Group A ◽  
Group B

<p class="abstract"><strong>Background:</strong> Chronic otitis media (COM) is an inflammatory process in the middle ear space that results in long-term changes in the tympanic membrane including atelectasis, dimeric-membrane formation, perforation, tympanosclerosis, retraction pocket or cholesteatoma. COM can be classified into healed, inactive (mucosal or squamosal), active (mucosal or squamosal). Myringoplasty is tympanoplasty without ossicular reconstruction. Cortical mastoidectomy is usually accompanied by tympanoplasty. Aim was to assess and compare the efficacy of myringoplasty with cortical mastoidectomy in dry and wet mucosal type of COM, in terms of graft uptake and hearing improvement.</p><p class="abstract"><strong>Methods:</strong> A prospective study, where 30 patients each of wet and dry mucosal-type COM were included. Patients underwent myringoplasty with cortical mastoidectomy. All were followed up for 6 months, both the groups were statistically compared.  </p><p class="abstract"><strong>Results:</strong> In our study, mean age of patients in group A (wet COM) was 34.13 years and group B (dry COM) was 33.36 years. Group A had success rate of 90% and group B had success rate of 86.6%. There was no statistical significance (p value- 0.53) on comparing both groups with respect to graft uptake. There was significant hearing improvement post-operatively in both the groups (p&lt;0.05). However, there was no significant difference between the groups (p value- 0.66). This shows that presence of discharge at the time of surgery does not interfere with the results of cortical mastoidectomy with myringoplasty.</p><p class="abstract"><strong>Conclusions:</strong> We conclude that, there is good outcome in both wet and dry COM following myringoplasty with cortical mastoidectomy with respect to graft uptake and hearing improvement.</p>

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 Comparison of the anatomical and functional success of fascia and perichondrium grafts in transcanal endoscopic type 1 tympanoplasty

2019 ◽  
Vol 48 (1) ◽  
Author(s):  
Kadir Özdamar ◽  
Alper Sen
Keyword(s):  
Retention Rates ◽  
Success Rates ◽  
Temporal Muscle ◽  
Type 1 Tympanoplasty ◽  
Significant Difference ◽  
The Status ◽  
Group A ◽  
Group B ◽  
Age Range

Abstract Background There are no studies in the literature, comparing the functional and anatomical successes of the use of fascial and perichondrial grafts in endoscopic type 1 tympanoplasties. Objectives To compare the anatomical and functional outcomes of grafting with the fascia of the temporalis muscle and with the perichondrium of the tragal cartilage in patients undergoing primary transcanal type 1 tympanoplasty with endoscopy. Methods We enrolled a total of 151 patients (80 females and 71 males with a mean age of 26.0 ± 9.3 years in the age range between 18-57) with MERI scores ranging from 1 to 3 and who underwent a transcanal endoscopic type 1 tympanoplasty without tympanomeatal flap elevation. The patients were assigned to two groups according to the type of the graft used. The patients were assigned to either the tragal cartilage perichondrium group (Group A) or the fascia of the temporal muscle (Group B). The groups were compared according to the pre- and postoperative air-bone gaps and to the status of the tympanic membrane. Results There were no statistically significant differences in the distribution of the age, gender, localization, MERI scores, the duration of the operation, and the size of the perforation (all p values> 0.05). The pre-operative air-bone gap values of Group A and B did not show a statistically significant difference (p = 0.073). The postoperative improvement in the air-bone gap value did not demonstrate a significant difference between Group A and B (p = 0.202). The graft retention rates were 94.9 and 97.2% in Group A and in Group B respectively. There were no statistically significant differences between the two groups in terms of the graft retention success rates (p = 0.743). Conclusion Perichondrium and fascia were suitable for use in endoscopic tympanoplasties.

Efficacy of Acetic Acid Irrigation in Management of Chronic Suppurative Otitis Media “A Prospective Study

2021 ◽  
Vol 15 (10) ◽  
pp. 3300-3303
Author(s):  
Nasir Riaz ◽  
Shakaib Faiz ◽  
Danish Hassnain ◽  
Ayesha Fayyaz ◽  
Tarique Khan ◽  
...  
Keyword(s):  
Acetic Acid ◽  
Otitis Media ◽  
Chronic Suppurative Otitis Media ◽  
Suppurative Otitis Media ◽  
Acid Versus ◽  
Acid Irrigation ◽  
Group A ◽  
Group B ◽  
A Prospective Study ◽  
Systemic Antibiotics

Background: Prior to surgical management of chronic suppurative otitis media (CSOM) for the dry ear medical management is necessary. CSOM is a biofilm disease and due to this has antibiotic resistance. The pillar of its treatment included aural cleaning according to standard protocols, application of topical germ free antiseptic and use of antimicrobials. Acetic acid due to its ability in reducing the pH may be effective in reducing the growth of microorganisms. Objective: The aim of the study was to compare the efficacy of irrigation with acetic acid versus systemic antibiotics in CSOM patients. Materials & Methods: A total of 134 patients, who came to the ENT department of Sheikh Zayed Hospital, Lahore between 1st April 2020 to 30th September 2020, who had CSOM, of age 15 to 55 years and both genders were included in the study. The patients were divided randomly into two groups. Group A patients received aural toilets and irrigation with acetic acid and Group B received 500 mg of ciprofloxacin twice a day for 2 weeks. Results: The mean age (in years) of the patients in Group A was 37.45±7.32 and in Group B, it was 37.96±7.57. The efficacy of irrigation with acetic acid versus systemic antibiotics was 89.55% and 68.66% respectively and this difference between the two groups was found to be statistically significant (p=0.003). Conclusion: Irrigation with acetic acid was better than systemic antibiotics in managing patients with CSOM. Key words: Acetic acid, CSOM, Middle ear

scholarly journals Endoscopic versus microscopic type 1 tympanoplasty in chronic suppurative otitis media- tubotympanic type

2020 ◽  
Vol 6 (4) ◽  
pp. 720 ◽  
Author(s):  
Kiran A. Deshmukh ◽  
Vinayak Kurle
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Conductive Hearing Loss ◽  
Chronic Suppurative Otitis Media ◽  
Medium Size ◽  
Microscopic Technique ◽  
Suppurative Otitis Media ◽  
Type 1 Tympanoplasty ◽  
Conductive Hearing

<p class="abstract"><strong>Background:</strong> Chronic suppurative otitis media attributes to 71.6% of hearing impairment in which most of them only have central perforations without any ossicular erosion or middle ear pathology. There are insufficient explanations to conclude which technique is better for type 1 tympanoplasty. Hence the study was conducted to compare and analyze the endoscopic technique with conventional microscopic technique for performing type 1 tympanoplasty.</p><p class="abstract"><strong>Methods:</strong> This prospective study was done at Basaweshwara teaching and general hospital attached to MR medical college, Kalaburagi from December 2015 to June 2017 after obtaining institutional ethical clearance. Patients were selected according to inclusion and exclusion criteria and randomly posted for surgery by either endoscopic or microscopic technique and results were analyzed.  </p><p class="abstract"><strong>Results:</strong> There were 60 patients in the study between 11-65 years with mean age of 28.85±10.87 years in which were 28 females and 32 were males. All patients were divided into 2 groups in which 30 underwent endoscopic and 30 underwent microscopic type 1 tympanoplasty. In this 46.7% of the patients had left ear conductive hearing loss whereas 31.7% of patients had right ear conductive hearing loss and 21.7% of the patients had bilateral conductive hearing loss which included 22 small perforations, 33 medium size perforations and 5 large perforations of pars tensa.</p><p class="abstract"><strong>Conclusions:</strong> We conclude that endoscope can be a better alternative for microscope in type 1 tympanoplasty as it provides a wide panoramic view, less operating time and hospital stay with negligible scar post operatively.</p>

scholarly journals A study on endoscopic type 1 tympanoplasty in tubotympanic chronic suppurative otitis media

2019 ◽  
Vol 5 (6) ◽  
pp. 1580
Author(s):  
Kiran A. Deshmukh ◽  
Vinayak Kurle
Keyword(s):  
Hospital Stay ◽  
Otitis Media ◽  
Middle Ear ◽  
Operating Time ◽  
Chronic Suppurative Otitis Media ◽  
Suppurative Otitis Media ◽  
Type 1 Tympanoplasty ◽  
Duration Of Surgery ◽  
The Mean

<p class="abstract"><strong>Background:</strong> Chronic suppurative otitis media (CSOM) attributes to 71.6% of hearing impairment in which most of them only have central perforation without any ossicular erosion or middle ear pathology. Tympanoplasty has evolved to provide and reconstruct better hearing mechanism, avoid complications as well as recurrence. Traditionally over the decades, tympanoplasty has been done using an operating microscope. Middle ear endoscopy was first introduced by Mer and colleagues in 1967, since then middle ear surgeries which were traditionally done using the microscope can be done using the endoscope also.</p><p class="abstract"><strong>Methods:</strong> This prospective study was conducted at Basaweshwar Teaching and General Hospital, Kalaburagi between March 2016 to November 2017. Endoscopic type 1 tympanoplasty was performed in all the cases using temporalis fascia.</p><p class="abstract"><strong>Results:</strong> There were 30 patients between 15-65 years with average being 29.6 years in which 17 were females and 13 were males. Pre and post-operative PTA at 1, 3 and 6 months were analyzed. The mean duration of surgery was 50.13 mins. The mean duration of hospital stay was 2.23 days. The mean duration of wound healing was 12.23 days. The average pre-operative PTA was 32.47±4.79 dBHL and postoperative PTA at 1, 3 and 6 months was18.3±3.22 dbHL, 16.5±2.2 dbHL and 16.35±2.22 dBHL. The graft uptake at end of 6 months was 100%.</p><p class="abstract"><strong>Conclusions:</strong> We here by conclude that endoscope can be a better alternative for microscope in type 1 tympanoplasty as it provides a wide panoramic view, less operating time and hospital stay with minimal visible scar post operatively.</p>

scholarly journals Correlation between degree of hearing loss and intraoperative findings in tubotympanic type of chronic suppurative otitis media

2018 ◽  
Vol 4 (2) ◽  
pp. 537 ◽  
Author(s):  
Ravi Dudda ◽  
Sowmya Tumkur Rangaiah ◽  
M. Hanumantha Prasad ◽  
Nagavara Kalegowda Balaji
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Otitis Media ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Ossicular Chain ◽  
Chronic Suppurative Otitis Media ◽  
Hearing Improvement ◽  
Suppurative Otitis Media ◽  
Significant Difference

<p class="abstract"><strong>Background:</strong> The aim of tympanoplasty done for tubotympanic type of chronic suppurative otitis media (CSOM) should not only be to achieve a dry ear, but also to give hearing improvement to the patient. Aim of this study was to determine the correlation between size and site of tympanic membrane perforation with degree of hearing loss and correlation between ossicular chain status and degree of hearing loss on pure tone audiometry.</p><p class="abstract"><strong>Methods:</strong> Patients with tubotympanic CSOM with hearing loss upto 60 dBHL undergoing tympanoplasty were examined to know the site and size of tympanic membrane(TM) perforation. Intraoperative findings pertaining to middle ear and ossicles were noted.  </p><p class="abstract"><strong>Results:</strong> Out of 52 patients of tubotympanic type of CSOM, hearing loss was least (31.18±7.46 dBHL) in small perforations of the TM and highest in subtotal perforations (48.74±7.83 dBHL) which was statistically significant. Hearing loss was significantly more in posterior perforation (46.61±7.02 dBHL) than in anterior perforation of TM (32.65±8.77 dBHL).<strong> </strong>There was a statistically significant difference in pure tone average hearing loss between intact ossicle group (32.87±9.77 dBHL)<strong> </strong>and eroded ossicle group (43.39±9.60dBHL). Difference in air bone gap was also significant between intact ossicle group (24.09±9.56 dB) and eroded ossicle group (31.02±9.83 dB). Multiple ossicles were eroded in nineteen patients with incus being the most commonly eroded ossicle.</p><p><strong>Conclusions:</strong> In this study, hearing loss increased with increased size of TM perforation and also with posterior perforation. Incus was found to be the most commonly eroded ossicle. Multiple ossicles were seen eroded most commonly when hearing loss was moderate. The surgeon will be better equipped to do ossiculoplasty in view of these preoperative findings and also to counsel the patient better about their expectation of hearing improvement following surgery. </p>

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