A clinical study of evaluation of tympanoplasty with mastoidectomy in mucosal chronic otitis media

Authors

  • Ritesh Mahajan Department of Otorhinolaryngology, Rajarajeswari Medical College and Hospital, Bangalore, Karnataka
  • Nidhi Abraham Department of Otorhinolaryngology, Rajarajeswari Medical College and Hospital, Bangalore, Karnataka
  • Nagaraj T. M. Department of Otorhinolaryngology, Rajarajeswari Medical College and Hospital, Bangalore, Karnataka

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20195709

Keywords:

Ear discharge, CSOM, Tinnitus, Tympanoplasty

Abstract

Background: Chronic suppurative otitis media (CSOM) is one of the most common ear diseases in developing countries with a varying incidence of 3% to 57%. It the disease process is further divided into mucosal type and squamosal type depending on clinical presentation. The mainstay of therapy in CSOM remains surgery which aims at eradication of disease and restoring the hearing mechanism. The main objective of our study was to evaluate the changes and impact of tympanoplasty with mastoidectomy as a surgical treatment modality in mucosal type of CSOM.

Methods: A prospective study was conducted in Rajarajeshwari Medical College and Hospital between November 2015 and June 2017, involving 50 patients with mucosal type of chronic otitis media. These patients, after complete clinical examination and hearing analysis, underwent tympanoplasty with cortical mastoidectomy. Follow-up of the patients was done at one month and three months after the surgery where the parameters recorded preoperatively were assessed.  

Results: The graft uptake three months after the surgery was 94%. Patients reported a subjective improvement in symptoms of ear discharge, decreased hearing, earache and tinnitus to 94%, 70%, 86% and 78% respectively. There was hearing improvement in ears that had discharge preoperatively and those ears that did not.

Conclusions: Chronic suppurative otitis media is a very common problem and it can lead to recurrent ear discharge and hearing problems. Timely intervention is necessary as early diagnosis results in good surgical outcomes and can make an impact on patient’s quality of life.

References

Acuin J. Chronic Suppurative Otitis Media: Burden of Illness and Management Options. Switzerland: World Health Organization, 2004. Available at: http://apps.who.int/iris/handle/10665/42941. Accessed on 17 October 2019.

Gupta A, Gupta. A study of prevalence of complications of suppurative otitis media in rural area of Loni. Ind J Otol. 1996;2:177-83.

Browning GG, Merchant SN, Kelly G, Swan LR, Canter R, McKerrow WS. Chronic otitis media. In: Gleeson M, Browning GG, Luxon LM (ed). Scott-Brown's Otorhinolaryngology. Head and Neck Surgery. 7th edition. Hodder Arnold; 2008: 3412.

Browning GG, Gatehouse S. The prevalence of middle ear disease in the adult British population. Clin Otolaryngol. 1992;17(4):317-21.

Nahata V, Patil CY, Patil RK, Gattani G, Disawal A, Roy A. Tympanic membrane perforation: Its correlation with hearing loss and frequency affected-An analytical study. Indian J Otol. 2014;20:10-5.

Fukuchi I, Cerchiari DP, Garcia E, Rezende CE, Rapoport PB. Tympanoplasty: surgical results and a comparison of the factors that may interfere in their success. Brazilian J Otorhinolaryngol. 2006;72(2):267-71.

Kumar N, Chilke D, Puttewar MP. 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. Indian J Otolaryngol Head Neck Surg. 2012;64(1):5-12.

Pinar E, Sadullahoglu K, Calli C, Oncel S. Evaluation of prognostic factors and middle ear risk index in tympanoplasty. Otolaryngol Head Neck Surg. 2008;139(3):386-90.

Pignataro L, Grillo della Berta L, Capaccio P, Zaghis A. Myringoplasty in children: Anatomical and functional results. J Laryngol Otol. 2001;115:369-73.

Jurado FJ, Gil JL, Secall MT, Vadillo ED, Palau EM, Novoa MD, et al. Myringoplasty: Auditory follow-up and study of prognostic factors. Acta Otorrinolaringologica (English Edition). 2009;60(3):169-75.

Rout MR, Mohanty D, Vijaylaxmi Y, Kamalesh B, Chakradhar M. Prevalence of cholesteatoma in chronic suppurative otitis media with central perforation. Indian J Otol. 2012;18:7-10.

Thakur SK, Ghimire N, Acharya R, Singh SK, Afaque A. The intraoperative pathological findings in cases of chronic suppurative otitis media with central perforation of tympanic membrane at a tertiary care centre in Eastern Nepal. Asian J Med Sci. 2017;8(1):42-7.

Yurttas V, Ural A, Kutluhan A, Bozdemir K. Factors that may affect graft success in tympanoplasty with mastoidectomy. ENT Updates. 2015;5(1):9.

Yuen AP, Ho WK, Hui Y, Wei WI, Au DK. Correlation of Pure Tone Audiogram results and hearing benefit of tympanoplasty for CSOM. Ann Otol Rhinol Laryngol. 2000;109:381-4.

Mishiro Y, Sakagami M, Kondoh K, Kitahara T, Kakutani C. Long-term outcomes after tympanoplasty with and without mastoidectomy for perforated chronic otitis media. Eur Arch Otorhinolaryngol. 2009;266(6):819-22.

Onal K, Uguz MZ, Kazikdas KC, Gursoy ST, Gokce H. A multivariate analysis of otological, surgical and patient-related factors in determining success in myringoplasty. Clin Otolaryngol. 2005;30(2):115-20.

McGrew BM, Jackson CG, Glasscock ME. Impact of mastoidectomy on simple tympanic membrane perforation repair. Laryngoscope. 2004;114:506-11.

Jackler RK, Schindler RA. Role of the mastoid in tympanic membrane reconstruction. Laryngoscope. 1984;94(4):495-500.

Garg S, Kakkar V. Doing Mastoidectomy Along with Tympanic Membrane Repair Reduces the Need for Revision Procedures: A Prospective Study. Indian J Otolaryngol Head Neck Surg. 2018;70(2):262-6.

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Published

2019-12-23

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Original Research Articles