Efficacy of Tympanomastoid Surgery for Control of Infection in Active Chronic Otitis Media (original) (raw)
Related papers
International Archives of Otorhinolaryngology, 2014
Introduction: Chronic otitis media (COM) is an inflammatory condition associated with otorrhea as well as large and persistent perforations of the tympanic membrane in some cases. COM can also lead to cholesteatoma. Surgical treatment with canal walldown and canal wall-up tympanomastoidectomy is considered for both types of illness. The choice of technique is controversial and is dependent on several factors, including the extent of disease. Objective: We aimed to evaluate surgical outcomes in COM patients with and without cholesteatoma treated with canal walldown and canal wall-up tympanomastoidectomy. Disease eradication and post-operative auditory thresholds were assessed. Method: Patient records from the otorhinolaryngology department of a tertiary hospital were assessed retrospectively. Results: Patients who underwent canal wall-up tympanomastoidectomy had a higher rate of revision surgery, especially those with cholesteatoma. However, there were no statistically significant differences in post-operative hearing thresholds between the two techniques. Conclusion: The canal wall-down technique is superior to the canal wall-up technique, especially for patients with cholesteatoma.
Audiology research, 2017
The overall number of day-case otologic surgery cases is increasing; however, there is limited experience about performing canal wall down tympanoplasty in patients with chronic suppurative otitis media with cholesteatoma in this setting. The objective of this study was to assess the success of this technique as daycase surgery in terms of results and complications over an 8-year follow up period. We included in this study 42 patients undergoing canal wall down technique tympanoplasty surgery for chronic suppurative otitis media with cholesteatoma performed as day cases during a 2-year period. 30 cases (71.4%) were discharged on the day of surgery, whereas 12 cases (28.6%) were hospitalized and discharged the day after. The principal reasons for failure of discharge on the day of surgery were asthenia (6 cases), vertigo and asthenia (4 cases), undetermined (2 cases). Based on our experience, with a proper preoperative selection, assessment and screening of the patients, mastoidectomy with timpanoplasty for chronic suppurative otitis media with cholesteatoma can be carried out in a day surgery setting without affecting results, complications and long-term relapse.
Journal of Evidence Based Medicine and Healthcare
BACKGROUND Chronic Otitis Media (COM), mucosal disease is a common ailment with which patients present to the ENT outpatient department. Tympanoplasty is the surgery performed with the goals of establishing an intact tympanic membrane, eradicating middle ear disease, creating an air-containing middle ear space and restoring the hearing by building a secure connection between the eardrum and the cochlea. The success of tympanoplasty depends on various factors including patient factors, disease factors and surgical factors. The aim of the study is to assess the present status and impact of tympanoplasty as the surgical treatment modality in cases of COM mucosal disease. MATERIALS AND METHODS 50 patients were selected by non-probability convenience method of sampling and were assessed prior to surgery. Tympanoplasty was carried out in all patients and they were assessed following surgery at 3, 6 and 12 months, respectively. Statistical analysis was done of the improvement following tympanoplasty. RESULTS The analysis carried out revealed the graft take up rate to be 86% with failure in 7 (14%) patients. Of the factors contributing to failure following tympanoplasty, the statistically significant factors in this study were the status of middle ear mucosa and the status of the opposite ear (p <0.05). Tympanoplasty continues to be an effective surgical modality of management in patients with COM, mucosal disease with a guarded prognosis in those having bilateral disease and persistent mucosal disease of middle ear cleft. CONCLUSION Tympanoplasty is the definitive and effective surgical modality in management of patients with COM mucosal disease. Of the factors considered relevant in the success of tympanoplasty, the status of middle ear mucosa and status of the opposite ear were found statistically significant in this study.
Surgical Outcomes of Chronic Suppurative Otitis Media
Bangladesh Journal of Otorhinolaryngology, 2020
Objectives: The purpose of this study is to observe the surgical outcomes of chronic suppurative otitis media. 1. To assess the result of surgical procedure to obtain dry and safe ears. 2. To assess the hearing levels after surgery. 3. To observe the complications that occur during the operation and in the immediate postoperative period Methods: A total 60 patients with CSOM (active squamous variety) who underwent tympanomastoid surgery studied in a period of 1 year from July 2013 to June 2014 at CMH Dhaka. Results: The maximum patients were from15-24 years (35%) age group, male to female ratio was 1.2:1. Highest number of patients (39%) was from middle class family. All the 60 patients presented with discharge from ear and hearing impairment. Maximum (40%) were with attic and postero-superior marginal perforation along with granulation tissue. In 1stpost op month,53 (88.33%) manifested dry ear and in 3rd month after operation 52 (90%) patients manifested dry ear. 7 (11.66%) patient...
Evaluating Success of Surgery in Mucosal and Squamosal Chronic Otitis Media: A Retrospective Study
Bengal Journal of Otolaryngology and Head Neck Surgery, 2018
This study attempted to document success of surgery postoperatively, be it type I tympanoplasty or type III tympanoplasty with or without modified radical mastoidectomy. Materials and Methods This retrospective study involved 90 patients of Chronic Otitis Media who underwent surgery in the Department of Otorhinolaryngology in a tertiary care centre in the state of Uttar Pradesh. Results At 3 week postoperatively, 83 patients (92.22%) had successful uptake of graft. Overall successful graft uptake was reduced to 87.78% (79 patients) after 3 months. Postoperatively, after 3 months, 90% of the patients (n=81) reported improvement in hearing. Preoperatively, 89.71 % patients of mucosal disease and 63.64% of squamosal disease had 21-40 dB hearing loss. Postoperatively, 88.24% patients with mucosal disease and 63.64% of squamosal disease had no conductive hearing loss. There was statistically significant gain in air conduction postoperatively. Average impr...
Complications of chronic otitis media with cholesteatoma
2013
We review and discuss the results of treatments for complications of cholesteatomatous chronic otitis media (CCOM) in a tertiary health care center. In a retrospective study, the medical records of patients with complications of CCOM who had undergone surgical treatment at the ENT Clinic of the University Clinical Center of Kosovo for the period 1994-2004 were reviewed. From a total of 1,803 patients suVering from CCOM, in 91 patients, 55 (60.4%) men and 36 (39.6) women, one or two complications are recorded. The mean age of the subjects was 30 years, and the age range was from 1 to 76 years. Extracranial (EC) complications were observed in 52 cases (57.1%), and intracranial (IC) complications were seen in 29 patients (31.9%). Twelve patients (11%) had multiple complications. For the EC cases, we found that subperiostal mastoidal abscess occurred in 26% of the all patients, facial nerve palsy was seen in 16.48% and labyrinthine Wstula occurred in 10%. For the IC cases, meningitis (19.7%) and perisinusal abscess (15.3%) were the most common complications. The most often isolated pathogen from ear swabs was Proteus mirabilis in 33.3% of cases. The most frequent radiological diagnostic procedures were mastoid tip X-rays, which were performed in 77% of the patients, and computed tomography in 24%; magnetic resonance imaging was not performed on any of the patients during the study period. Patients with EC complications were treated in the ENT Clinic, whereas patients with IC complications, after otologic surgical procedures, were transferred to the Neurosurgery Clinic or to the Clinic for Infectious Diseases. In this series, three patients (3.3%) died as a result of complications, while the remaining 96.7% survived. Complications of COM with cholesteatoma can represent life-threatening conditions, and close cooperation between otosurgeons, neurosurgeons and infectious disease specialists is mandatory.
Ear, Nose & Throat Journal, 2007
We obtained the charts of 183 patients (197 ears) who had undergone surgery for chronic otitis media (COM), and we reviewed their otic histories to analyze the series of events that ultimately culminated in surgery. All ears had originally been treated for otitis media with effusion (OME); 125 ears had been treated with tympanostomy tube placement, and 72 ears had been treated with conservative measures. Our goal was to compare the influence that these two strategies had on the subsequent development of COM and its sequelae (i.e., retraction pockets, tympanic membrane perforations, and cholesteatomas) and thereby determine which strategy is preferable. We found that although retraction pockets developed in a significantly higher proportion of the tympanostomy-treated ears than the conservatively treated ears (58 vs. 35%; p < 0.01), a significantly greater percentage of retractions in the tympanostomy-treated ears were mild and situated in the anterior part of the tympanic membran...
Current trends in the management of the complications of chronic otitis media with cholesteatoma
Current opinion in otolaryngology & head and neck surgery, 2013
Complications of cholesteatoma can be of a different nature from those of other otitis media. This review aims to undertake an analysis of current literature regarding management of the complications of cholesteatoma. Despite a significant decline in the incidence of complications secondary to cholesteatoma in developed countries it is still a considerable problem in the developing countries. Among intratemporal complications, facial nerve paralysis and labrynthine fistula and among intracranial complications, meningitis, brain abscess and lateral sinus thrombosis are most common. In cases of facial nerve paralysis, decompression with complete disease eradication is considered to be the mainstay of treatment and usefulness of an epineural incision and the range of the decompression are still debatable. Labyrinthine fistula is commonly managed by a single staged matrix removal, followed by closure of the fistula. Partial labrynthectomy in difficult cases is gaining favor among surgeo...
Indian Journal of Otolaryngology and Head & Neck Surgery, 2017
To compare the outcome of type I tympanoplasty with cortical mastoidectomy in chronic otitis media active mucosal disease (wet ear) versus chronic otitis media inactive mucosal disease (dry ear). An observational analytic study was conducted and data collection was done from August 2014 to August 2016. All patients of chronic otitis media with mucosal disease were divided into two groups, one with active disease (group A) and another with inactive disease (group B). The outcome was studied in the form of graft take up rate. Total 103 patients were studied, group A (wet ear) had 67 and group B (dry ear) had 36 patients. Graft take up rate was 94% in wet ear and 100% in dry ear and p value was 0.2. There was no statistically significant difference found between the two groups. Keywords Wet ear Á Dry ear Á Active versus inactive disease Á Mucosal disease Á Chronic otitis media Á Type I tympanoplasty