Abstract

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Introduction Chronic otitis media (COM) is a common problem affecting 65 to 330 million population worldwide with 50% patients suffering from hearing impairment. In active COM, the usual clinical practice is to wait for the ear to become dry and to consider tympanoplasty with/without cortical mastoidectomy. If cortical mastoidectomy can be avoided without compromising the outcomes, it is desirable. Various prognostic factors have been studied; however, the effect of altitude on the outcome of tympanoplasty has not been commonly studied. High-altitude areas can have poor connectivity and can result in middle ear pressure changes when the patients commute from low-altitude areas. Aim The aim of this article was to assess the surgical outcome in patients undergoing tympanoplasty for active COM mucosal type in comparison to inactive COM mucosal type in a hilly area located at an altitude of 4,757 ft (1,450 m). Objective This article compared the success rate and audiometric improvement in patients undergoing tympanoplasty for active COM mucosal type and inactive COM mucosal type. Materials and Methods This prospective cohort study included 24 patients with 12 patients each in active and inactive groups. At 3 months follow-up, there was significant improvement in all the air conduction threshold frequencies and air bone gap in both the groups. Conclusion The success rate for our tympanoplasties for active and inactive COM performed in a hilly area was 92% and it was comparable to those reported from other centers. Altitude may not negatively affect the outcome of tympanoplasty and that the active ear COM can have similar success rate as inactive COM tympanoplasty.

Colostomy shift en masse is a novel technique in which the colostomy is shifted along with a rim of skin and abdominal wall tissue. This provides additional length of distal bowel if needed during pull-through anastomosis. We have treated three cases (two Hirschsprung's disease and one anorectal malformation) with colostomy shift en masse, and have achieved good results.

doi: 10.3329/jcmcta.v18i1.3819Journal of Chittagong Medical College Teachers' Association 2007: 18(1):32-34