Clinical Profile of Tubotympanic CSOM and Its Management With Special Reference to Site and Size of Tympanic Membrane Perforation, Eustachian Tube Function and Three Flap Tympanoplasty

Kumar, Naresh; Chilke, Devashri; Puttewar, M. P.

doi:10.1007/s12070-010-0114-5

Cited by 48 publications

(64 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A normally functioning Eustachian tube is also an essential physiologic requirement for a healthy middle ear and normal hearing. 8 Posterior quadrant perforations have more hearing loss than anterior quadrant perforation, may be because of round window exposure and a higher incidence of ossicular fixation. Posteroinferior perforations abolish the sound protection of the round window and hence, they will cause more hearing loss than perforations in other quadrant.…”

Section: Introductionmentioning

confidence: 99%

Tympanic membrane perforation: correlation of hearing loss with its site and size

Pal

Kumar

2018

Int J Otorhinolaryngol Head Neck Surg

View full text Add to dashboard Cite

Background: The objectives of the study were correlation of hearing loss with size and site of tympanic membrane perforation. Methods: A cross-sectional prospective study of 100 patients of both sex and age between 11-60 years with perforated tympanic membrane was conducted in the department of Otorhinolaryngology (ENT). Size and site of TM perforation was assessed using otoscope and otomicroscope. Size of perforation was measured with 1 mm thin wire loop and vernier caliper. Patients were divided into three groups according to size; Group I (0-9 mm), Group II (9-30 mm), Group III (>30 mm). The tympanic membrane was divided into five segments anterosuperior, posterosuperior, anteroinferior, posteroinferior and central for the localization of the site of perforation. Data thus collected was statistically analysed. Results: Patients with Group I perforation had an average hearing loss of 31.42±7.15 decibel. Group II had an average hearing loss of 39.42±8.97 decibel. Group III had an average hearing loss of 48.91±7.38 decibel. Maximum hearing loss was noted in patients with central perforation with an average hearing loss of 39.34±9.47 decibel. Average hearing loss was found higher in posterior perforations than anterior quadrant perforations. This difference was however not statistically significant with ‘p’ value of ‘0.689’. Conclusions: Linear correlation was found between size of tympanic membrane perforation and degree of hearing loss. No linear correlation between site of tympanic membrane perforation and hearing loss was found. We found no correlation between duration of disease and size of tympanic membrane perforation with degree of hearing loss.

show abstract

Section: Introductionmentioning

confidence: 99%

Tympanic membrane perforation: correlation of hearing loss with its site and size

Pal

Kumar

2018

Int J Otorhinolaryngol Head Neck Surg

View full text Add to dashboard Cite

show abstract

“…1 There were various new techniques tried in desire to overcome the problems encountered in the reconstruction of the tympanic membrane. Among these problems are poor exposure to vital areas of the tympanic cavity like sinus tympani, difficulty in removing all squamous epithelium in the area to be covered by the graft and the subsequent formation of epithelial pearls, development of disease sequelae such as tympanosclerosis or the appearance of cicatricle tissue, blunting of the anterior canal recess, postoperative migration of the tympanic membrane graft away from the handle of the malleus and retraction of the grafted tympanic membrane, delayed epithelisation of the graft, early or late acute middle ear infection and eventual graft failure, too thick or too thin neotympanum and hearing loss.…”

Section: Introductionmentioning

confidence: 99%

Comparison of surgical outcomes of tympanoplasty assisted by conventional microscopic method and endoscopic method

Shoeb¹,

Gite²,

Bhargava³

et al. 2016

Int J Otorhinolaryngol Head Neck Surg

View full text Add to dashboard Cite

Background: The introduction of the operating microscope has significantly enhanced the outcome of tympanoplasty by improving the accuracy of the technique. The operating microscopy provides a magnified image in straight line; hence the surgeon can’t visualize the deep recesses of the middle ear in single operating field. This is overcome by use of rigid endoscope for tympanoplasty. In rigid endoscopy view is better but surgeons 2 hands are not free so manipulation here is difficult.Methods: 30 cases of safe CSOM from each group viz microscopic assisted (MES) & endoscopic assisted (EES) were selected operated by full cuff (superiorly based tympanomeatal flap technique) and compared for graft uptake, hearing improvement & complications.Results: Graft uptake rate was 93.33% in both groups. In our study the pre operative mean air bone gap of the patients was 37.23+5.79 db after surgery at 6 months came down to 17.17+3.31 db hence after calculating the mean air bone gap closure it came down to be 20.4+4.85. Which showed a significant improvement in the hearing (p value 1.493E-23 which is less than 0.05). 6.67% cases from both groups showed failure of graft uptake.Conclusions: The graft uptake, hearing improvement, Complications produced by each of the techniques in large, subtotal, and anterior moderate perforations by each technique is comparable i.e. both techniques have same results.

show abstract

“…However, Kumar et al in their study observed that 43.75% had moderate TM perforation, 14.06% had large TM perforation and 32.81% had subtotal TM perforation. 18 Shivakumar et al observed that 57% of the cases had medium-sized perforation while small perforation was seen in 43% of the cases. 16 The study included 63.33% cases of sclerotic mastoid, 23.33% cases of pneumatic mastoid and 13.33% cases of diploic mastoid.…”

Section: Discussionmentioning

confidence: 98%

Factors Influencing Surgical Outcome of Myringoplasty in Tubotympanic Type of Chronic Otitis Media

Das¹,

Das²

2017

jemds

View full text Add to dashboard Cite

BACKGROUNDChronic otitis media is an inflammatory process of the mucoperiosteal lining of the middle ear space and mastoid. Infection of the middle ear has been a problem encountered in the human race, and is as old as humanity itself. Chronic suppurative otitis media (CSOM) is one of the most common causes of ear infection in developing countries particularly in South-east Asian countries. Chronic middle ear disease is a major problem in India especially in the rural areas. It is estimated that 6% of Indian population suffers from chronic ear disease. The term "Tubotympanic disease" is sometimes used to describe COM with a central perforation. The two principal aims of management of tubotympanic chronic otitis media are the eradication of infection and improvement of hearing by the closure of the tympanic membrane perforation which can be achieved either conservatively or by surgery. The surgical treatment of CSOM is still controversial. Some surgeons advice only repair of central perforation of tympanic membrane in non-cholesteatomatous tubotympanic chronic otitis media using graft i.e. myringoplasty to achieve a dry ear with improved hearing. This study aims to determine the factors responsible for successful surgical outcome of myringoplasty. MATERIALS AND METHODSThis hospital-based prospective study was done in the Dept. of ENT, Assam Medical College and Hospital, Dibrugarh from 1 st January 2015 to 31 st December 2015 in diagnosed cases of tubotympanic variant of CSOM. Thirty patients were included in this study after fulfilling inclusion and exclusion criteria. The surgical outcomes were assessed in terms of hearing gain, graft uptake and dryness of ear. RESULTSThirty patients of tubotympanic type of CSOM reviewed in the study with mean age group of 35.16 + 12.75 years underwent myringoplasty. Successful graft uptake post-operatively at 3 rd followup (12 th week) was seen in 83.33%. Dry ear was achieved at the end of 12 th week in 86.67% and gain in hearing at 3 rd post-operative review was 9.90 + 1.81 dB. 5 cases had graft failure, 4 cases failed to achieve dry ear. Extremity of ages, lower socio-economic status, postoperative URTI and ET dysfunction, disease in contralateral ear were associated factors in determining graft uptake and dry ear. CONCLUSIONMyringoplasty has been established as a very effective surgical management of tubotympanic variant of CSOM. Success of myringoplasty can be measured in terms of gain in hearing, graft uptake and dry ear. Our study acknowledges that successful outcome of surgery is determined by a range of factors like lower socio-economic status particularly in rural population with unhygienic living conditions, presence of nidus of infection in the upper airway along with eustachian tube dysfunction, otitis externa, disease in contralateral ear may be considered as some of the possible factors responsible for influencing the outcomes of surgery in tubotympanic type of chronic otitis media. But we emphasised that more cases or study population for longer duration...

show abstract

Clinical Profile of Tubotympanic CSOM and Its Management With Special Reference to Site and Size of Tympanic Membrane Perforation, Eustachian Tube Function and Three Flap Tympanoplasty

Cited by 48 publications

References 14 publications

Tympanic membrane perforation: correlation of hearing loss with its site and size

Tympanic membrane perforation: correlation of hearing loss with its site and size

Comparison of surgical outcomes of tympanoplasty assisted by conventional microscopic method and endoscopic method

Factors Influencing Surgical Outcome of Myringoplasty in Tubotympanic Type of Chronic Otitis Media

Contact Info

Product

Resources

About