A STUDY ON OSSICULOPLASTY

The diagnosis of chronic otitis media (COM) implies a permanent abnormality of the pars tensa or acida, most likely a result of earlier acute otitis media, negative middle ear pressure or otitis media with 1 2 effusion . Ossiculoplasty is a micro surgical operative procedure, performed to repair or reconstruct the ossicular chain . Present study was done to nd out the epidemiology and hearing result after ossiculoplasty. Materials and methods Study design –Retrospective study Study setting – Tertiary care hospitals in south India. Study period - Over a period of 3 years (from July 2017 to June 2020) Sample size – 55 Methodology - All the patient with COM and ossicular chain damage were considered for study. Data was collected from the medical record department and analyzed. Results - Study was to be done to nd out the natural behavior of the disease, COM with ossicular damage and how it can be managed effectively. In our study of 55 cases of ossiculoplasty, followings are nding1. 52.72% are male and 47.27% are female. And the male to female ratio is 1.11:1. 2. Mean age of the patient is 27.63. 3. Most common ossicle involved was incus. 4. Mean improvement in ABG is 15.49 and in 87.2% of patients ABG closure was with in 20dB.

Ossiculoplasty using Autologous Reshaped Incus and Teflon PORP: A Comparative Study

Introduction Autologous reshaped Incus and Teflon partial ossicular replacement prosthesis (PORP) are commonly used for ossicular chain reconstruction. The present study attempts to assess the post-operative outcome with these two prostheses. Materials and Methods A Randomized prospective study was conducted in Tertiary referral care hospital to determine which material, among autologous reshaped Incus and Teflon partial ossicular replacement prosthesis (PORP) gives better postoperative hearing result in Ossiculoplasty. Patients presenting at outpatients’ department with the clinical diagnosis of chronic otitis media with perforation or retraction. The study population consisted of a total of 50 patients. Ossiculoplasty with reshaped Incus or PORP was performed after Canal Wall Up mastoidectomy. Hearing results were measured by Air-Bone gap in PTA after 6 months of surgery. Results Selecting the criteria <20 dB ABG as success when Stapes superstructure is present, Incus has 64.29% success rate, whereas PORP has 31.81% success. Extrusion rate of different prosthesis shows PORP has 18.18% extrusion whereas autologous Incus has lower (7.14%) extrusion rate. Conclusion Among these two ossiculoplasty materials, autologous Incus gives better postoperative hearing gain and lower extrusion rate.

Bone versus cartilage ossiculoplasty: a case series

<p class="abstract"><strong>Background:</strong> Ossiculoplasty can be done by using both autologous bone and cartilage. Few literature shows cartilage is better and few shows bone is better. This study has been done to compare the both type of ossiculoplasty and find out the better one by comparing the hearing results.</p><p class="abstract"><strong>Methods:</strong> Present study is a retrospective study with 6 years data collected from the inpatient’s records. It was conducted in the department of ENT, in a tertiary care hospital of South India. Total number patients studied were 200. Patients with chronic ear disease having ossicular chain defects were evaluated for study. Two types of ossiculoplasty were performed (malleus-stapes assembly and membrane to stapes head interposition) using both cartilage and bone (each 100 patients). Postoperatively hearing result was evaluated at 1month, 6 months and 1 year and statistical analysis was done using z’ test. </p><p class="abstract"><strong>Results:</strong> Hearing improvement was better with bone ossiculoplasty then cartilage type. Average hearing gain was 33.34dB in bone where as in cartilage it is 29.34 dB. Average improvement in air bone gap is 21dB in bone type, whereas 19dB in cartilage type. But when we applied z’ test, it showed z’ value as 1.4506 indicating insignificant (z’ value should be &gt;1.96).</p><p class="abstract"><strong>Conclusions:</strong> Study shows that, clinically bone ossiculoplasty is superior to cartilage in terms of hearing improvement. But it is statistically not significant.</p>

Does Anterior Tunnelling Really Help in Underlay Type I Tympanoplasty?

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.