Graft uptake and post-operative hearing outcome with type-I tympanoplasty in dry versus wet ear: a comparative study
DOI:
https://doi.org/10.18203/issn.2454-5929.ijohns20194926Keywords:
Wet ear, Type 1 tympanoplasty, Temporalis fasciaAbstract
Background: The discharging ear presents the otologist with the dilemma of operating on it or not. This study is being undertaken to study and compare the results of type I tympanoplasty in dry ear (no ear discharge at the time of surgery) and wet ear (culture negative consistent ear discharge at the time of surgery).
Methods: 50 patients of either sex aged between 18 to 50 years undergoing type-I tympanoplasty were included in the study on the basis of pre-determined clinical criteria. Type I tympanoplasty was performed using temporalis fascia graft by underlay technique. Post-operative data regarding graft uptake and hearing improvement was recorded in the follow up period of three months.
Results: The complete graft uptake was there in 88% of the patients in group 1 and 84% patients in group 2. The difference in the two groups was statistically insignificant (p>0.05). The mean pre-operative pure tone average in group 1 was 30.57±7.80 dB while post-operative pure tone average was 20.68±8.22 dB with a mean hearing gain of 9.89 dB. The mean pre-operative pure tone average in group 2 was 35.21±5.98 dB while the post-operative pure tone average was 27.07±9.25 dB with a mean hearing gain of 8.12 dB. There was marked hearing improvement in both the groups post operatively (p<0.001 i.e., highly significant). When hearing improvement was compared between two groups there was no significant statistical difference (p>0.05).
Conclusions: The outcome is equally good for type 1 tympanoplasty in dry and wet ear in safe (mucosal) type of chronic suppurative otitis media with respect to graft uptake and hearing improvement.
References
WHOCIBA Foundation workshop. Prevention of hearing impairment from chronic otitis media. WHO/PDH/98.4. London, UK: CIBA Foundation; 1996.
Browning GG. Aetiopathology of inflammatory conditions of the external and middle ear. Scott-Brown’s Otolaryngol. 1997;3:15-28.
Krishnan A, Reddy EK, Nalinesha KM, Jagannath PM. Tympanoplasty with or without cortical mastoidectomy-a comparative study. Indian J Otolaryngol Head Neck Surg. 2002;54(3):195-8.
Ballenger JJ, Snow JB. Ballenger's otorhinolaryngology: head and neck surgery. Shelton, USA: People’s Medical Publishing House; 2003.
Brackmann D, Shelton C, Arriaga MA. Otologic Surgery. 3rd edition. Philadelphia, PA: Elsevier; 2015: 119-60.
Nagle SK, Jagade MV, Gandhi SR, Pawar PV. Comparative study of outcome of type I tympanoplasty in dry and wet ear. Indian J Otolaryngol Head Neck Surg. 2009;61(2):138-40.
Thakur SK, Singh SK, Afaque A, Ghimire N. Outcome of type 1 tympanoplasty: an experience at Biratnagar eye hospital in Eastern Nepal. Asian J Med Sci. 2015;7(2):55-60.
Shetty S. Pre-operative and post-operative assessment of hearing following tympanoplasty. Indian J Otolaryngol Head Neck Surg. 2012;64(4):377-81.
Mills R, Thiel G, Mills N. Results of myringoplasty operations in active and inactive ears in adults. Laryngoscope. 2013;123(9):2245-9.
Dhar G, Basak B, Chandra Gayen G, Ray R. Outcome of myringoplasty in dry and wet ear–a comparative study. J Dental Med Sci. 2014;13:2279.
Hosny S, El-Anwar MW, Abd-Elhady M, Khazbak A, El Feky A. Outcomes of myringoplasty in wet and dry ears. J Int Adv Otol. 2014;10(3):256.
Shankar R, Virk RS, Gupta K, Gupta AK, Bal A, Bansal S. Evaluation and comparison of type I tympanoplasty efficacy and histopathological changes to the tympanic membrane in dry and wet ear: a prospective study. J Laryngol Otol. 2015;129(10):945-9.