Background: Chronic otitis media is otological challenge in the developing countries it is particularly single most common cause of hearing impairement. Objective: The objective of this study was to observe the impact of prognostic factor middle ear risk index on hearing of patients undergoing tympanoplasty for chronic otitis media. Methods: This was a prospective analytical study conducted in 50 patients planned for tympanoplasty for chronic otitis media and evaluation done by MERI (Middle Ear Risk Index) and pure tone audiometry. Results: This study shows that most of the patients had mild MERI (64%), followed by severe MERI (20%) and then moderate MERI (16%). The mean preoperative PTA average was 44.34 dB (SD 8.01 dB) for patient with mild MERI, 44.75 dB (SD 5.87 dB) for patient with moderate MERI, and 54.9 dB (SD 14.05 dB) for patient with severe MERI and the mean preoperative A-B gap was 37.36 dB (SD 5.73 dB). Post operatively for mild MERI mean hearing gain is 12-14dB, for moderate MERI mean hearing gain is 10-13dB and for severe MERI mean hearing gain is 10-13dB and post operative mean A-B gap was improved by 10-11dB. There is a statistically significant hearing improvement in A-B gap with different types of MERI. Conclusion: MERI scoring is useful for predicating the outcome of hearing after tympanoplasty.
Introduction: Tympanoplasty is typically performed in conjunction with a canal wall down mastoidectomy in patient with Chronic Otitis Media Squamous. The results from experimental and clinical studies of the type III stapes columellar reconstruction have shown that interposing a disk of cartilage between the graft and the stapes head improves hearing in the lower frequencies by 5 to 10 dB. They hypothesize that the cartilage acts to increase the “effective” area of the graft that is coupled to the stapes, which leads to an increase in the middle ear gain of the reconstructed ear. Aims: To assess the hearing improvement after cartilage augmented Type III Tympanoplasty in chronic otitis media squamous disease. Methods: This study was conducted in 44 patients with Chronic Otitis Media squamous in the patients attending the department of Otorhinolaryngology in NGMC teaching hospital from November 2018 to March 2020. Canal Wall Down mastoidectomy with cartilage augmented type III Tympanoplasty and was done. Augmentation was done with thin 3-4 mm conchal cartilage interposed between stapes and Temporalis fascia graft. Results: There were 11(25%) male and 33(75%) female, with mean age of 29.48 years, ranging from minimum of 15 years to maximum 56 years. The preoperative mean A–B gap was 21.82 and postoperatively means AB gap was 12.20 dB with overall AB gap gain was 9.64 dB. Conclusion: Significant hearing improvement is seen in Canal Wall Down mastoidectomy Chronic Otitis Media squamous after cartilage augmented type III tympanoplasty.
Background: Chronic rhino sinusitis with and without nasal polyps represent different group of one chronic inflammatory disease of the mucosa of the nasal cavity and paranasal sinuses. Coexistence of chronic rhinosinusitis with nasal polyps' has similar characteristics of inflammation that supports assumption that chronic rhinosinusitis and nasal polyps may at least be in part, the same disease process. Objectives: This study is aimed to correlate the chronic rhinosinusitis associated with nasal polyps. Methods: This was a prospective descriptive study was conducted on the patients attending the department of ENT in NGMC teaching hospital from March 2016 to September 2017. Result: There were 70 cases including 47male and 23 female, with an age range of 17 years to 65 years. Conclusion: This study supports that a patient with chronic rhinosinusitis associated with nasal polyps is a subtype of chronic sinus disease.
Introduction: Role of cortical mastoidectomy in tympanoplasty for Chronic Otitis Media Mucosal inactive disease is controversial. Some arguments are in favor and suggest that cortical mastoidectomy increases the air reservoir in the mastoid and also help in achieving the patency of aditus but others believe that the ingrowths of squamous epithelium, potential for injury to the inner ear structures and facial nerve during mastoid surgery outweighs the beneficial effects on tympanic membrane healing. Aims: To assess the hearing improvement and graft uptake in patients undergoing Tympanoplasty and Tympano-mastoidectomy in chronic otitis media mucosal inactive disease. Methods: This was a comparative study comprises of 50 patients with Chronic Otitis Media Mucosal inactive ear, conducted in the patients attending the department of ENT in NGMC teaching hospital from Nov 2017 to May 2019. All cases were operated during a period of one half year. 25 patients were selected for tympanoplasty (Group A) and 25 patients were selected for Tympanoplasty with cortical mastoidectomy (Group B). Results: There were 14(28%) male and 36(72%) female, with mean age of 28. 36 years, ranging from minimum of 13 years to maximum 56 years. The postoperative audiograms were recorded after 3 months. Type I tympanoplasty with cortical mastoidectomy has better graft uptake (96%) as compared to without mastoidectomy (84%). Post-operative hearing improvement is almost equal in tympano-mastoidectomy (13.24 dB) and tympanoplasty (13.04 dB). Conclusion: Post-operative hearing gain almost equal in both study group but graft uptake was better with tympano-mastoidectomy then tympanoplasty alone in present study.
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