Hearing outcomes after suppurative chronic otitis media surgery

Background: The objective of the study was to hear the results in patients with atticoantral-chronic otitis media who undergone canal wall down mastoidectomy with different types of tympanoplasty.Methods: 86 cases of CSOM-AA were included. Patients were divided in 3 groups according to intra-operative ossicular chain status and reconstruction. Group A were patients having intact stapes superstructure and the graft kept over the stapes head covering middle ear and mastoid cavity. Group B patients were with intact superstructure of stapes and graft kept over cartilage graft kept on mobile stapes head. Group C patients were with absent superstructure of stapes with intact, mobile footplate and graft kept over autologous or homologous cartilage kept on footplate of stapes. On 10th week and 24th week after surgery, PTA was carried out to compare pre and post-operative hearing status. The study was conducted at SMIMER Hospital, Surat (a tertiary health care hospital) fromSeptember 2016 to September 2017. Results: In 86 patients, average mean preoperative AC threshold was 48.16 (±15.15) dB, mean pre-operative BC was 8.96 (±7.85) dB and mean pre-operative air bone gap was 40.11 (±12.92) dB. The mean post-operative AC threshold was 43.17 (±13.72) dB, mean post-operative BC was 11.34 (±9.44) dB and postoperative air bone gap was 32.06 (±11.62) dB. The mean air bone gap closure was 8.76 (±11.86). This hearing gain was statistically highly significant (p<0.001). Among 86 patients, cartilage was used in total 60 patients. Mean ABG was 8.6 dB, 11.05 dB and 8.43 dB respectively for tragal, conchal and homologous septal cartilage. Conclusions: Hearing improvement can be achieved with appropriate reconstruction in CWD mastoidectomy.

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“…In our study mean pre-operative ABG was 40.11(±12.92) dB and post-operative ABG was 32.06 (±11.62) dB with ABG gain was 8.76 (±11.86) dB. 2…”

Section: Discussionsupporting

confidence: 45%

“…But this goal is not always attainable because inadequate or improper surgery can cause residual or recurrent disease. 2 Various autogenous and allogenous materials are available for ossiculoplasty. Autologous ossicles and cartilage are the first choices for ossiculoplasty.…”

Section: Introductionmentioning

confidence: 99%

Hearing results in modified radical mastoidectomy with type III tympanoplasty

Lavana

Panchal

Hapalia

et al. 2019

Int J Otorhinolaryngol Head Neck Surg

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“…Many factors are involved in hearing improvement after surgery including types of surgery, presence of ossiculoplasty, middle ear pathology, and Eustachian tube function. 18,19 We did not analyze many factors affecting postoperative hearing status. Also, our study differed from other studies in the average preoperative PTA level and ABG.…”

Section: Discussionmentioning

confidence: 99%

External Auditory Canal Reconstruction and Mastoid Obliteration Using Modified Palva Flap in Canal Wall Down Mastoidectomy With Tympanoplasty

Kim

Lim

et al. 2019

Ann Otol Rhinol Laryngol

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Objective: To evaluate the effectiveness of a modified Palva flap used for external auditory canal reconstruction and mastoid obliteration in canal wall down mastoidectomy. Methods: We retrospectively analyzed patients who underwent canal wall down mastoidectomy with tympanoplasty using modified Palva flap. All patients underwent pure tone audiometry and temporal bone computed tomography (CT) before surgery, and the same tests were performed in the first year after surgery. The external auditory canal volumes were calculated by summing the areas of each section selected in temporal bone CT. For each patient, the ratio of external auditory canal volume was calculated from CT taken before and after surgery. Results: The mean of external auditory canal volume after canal wall down with a modified Palva flap was about 1.4 times larger than before surgery. The modified Palva flap is effective for the reconstruction of the external auditory canal. Both pure tone audiometry level and air-bone gap showed statistically significant improvement after surgery ( Ps = .001 and .002, respectively). Conclusions: The external auditory canal volume slightly increased, but the status of mastoid obliteration was well maintained 1 year after surgery. The modified Palva flap used in this study is an easy and effective method in external auditory canal reconstruction and mastoid obliteration.

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“…From our results, it is clearly evident that in the case of tympanoplasty type III, an intact stapes and the anatomical height of the facial canal with respect to stapes head, that is, the height of the facial recess, are 2 important determinants for a good hearing gain postoperatively in cholesteatoma ear surgery. Importance of an intact stapes superstructure for good hearing results in cholesteatoma surgery has also been mentioned by Chang and Chen, De Corso et al, and Uyar et al 11,12,19 However, it would be important to note that these factors are difficult to assess preoperatively. Even the role of CT scan of temporal bone is disputed in resolution for stapes in cholesteatoma disease 20,21 In addition, the indications for type III tympanoplasty minor columella are not clearly defined in the literature.…”

Section: Hearing Gain In Type III Tympanoplasty Major Columellamentioning

confidence: 92%

Evaluation of Type III Tympanoplasty Using Cartilage Ossiculoplasty in Cholesteatoma Ear Surgery

et al. 2019

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This prospective observational study evaluates the role of tympanoplasty type III in cholesteatoma ear disease during same sitting with mastoid surgery using cartilage ossiculoplasty. Forty patients of chronic suppurative otitis media-cholesteatoma disease were recruited in the study. All the patients had extensive cholesteatoma and underwent canal wall down mastoid surgery. Tympanoplasty type III, that is, stapes columella, minor columella, or major columella, was done in each case along with mastoid surgery depending upon the remnant ossicular status. Conchal cartilage graft was used for ossiculoplasty along with temporalis fascia graft. Hearing and graft uptake results were evaluated at the end of 6 months postoperatively. Of the 40 cases, 3 cases failed tympanoplasty. In the remaining 37 cases, a statistically significant hearing improvement (air–bone gap of 33 dB) was observed postoperatively. Seven cases underwent stapes columella, 13 cases underwent minor columella, and 17 cases underwent major columella tympanoplasty type III. Although a hearing improvement was recorded in all these subgroups, a statistically significant hearing gain was present only in tympanoplasty type III minor columella cases thereby underlying the importance of intact stapes. However, it is difficult to discern the type of tympanoplasty type III that the patient would undergo prior to the ear surgery

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Hearing outcomes after suppurative chronic otitis media surgery

Abstract: The pathology affecting the middle ear had influence on the hearing results of the two groups. Canal wall down mastoidectomy may be a beneficial procedure to improve hearing in patients with CSOM.

Cited by 6 publications

References 13 publications

Hearing results in modified radical mastoidectomy with type III tympanoplasty

Hearing results in modified radical mastoidectomy with type III tympanoplasty

External Auditory Canal Reconstruction and Mastoid Obliteration Using Modified Palva Flap in Canal Wall Down Mastoidectomy With Tympanoplasty

Evaluation of Type III Tympanoplasty Using Cartilage Ossiculoplasty in Cholesteatoma Ear Surgery

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