Outcome of ear surgeries in dry and wet ear

Authors

  • Shreyash C. S. Maddur, Mandya, Karnataka, India
  • Rajneesh . Shree ENT Clinic, Gulberga, Karnataka, India
  • Rahul S. Department of ENT, ESIC Medical College, Gulberga, Karnataka, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20172103

Keywords:

Type 1 tympanoplasty, Cortical mastoidectomy, Dry ear, Wet ear, Chronic otitis media

Abstract

Background: Chronic suppurative otitis media (CSOM) can present with dry and wet ear (discharging ear). It’s an accepted fact that an actively draining central perforation is not a contraindication for ear surgery. The discharging ear presents the otologists with the dilemma of operating on it or not, this is due to widespread belief that the success rate while doing ear surgeries on wet ears is decidedly inferior. Hence the present dissertation is intended to find the outcome of ear surgeries in dry and wet ear.

Methods: The present study comprises of 60 patients who have undergone type 1 tympanoplasty with cortical mastoidectomy, at Fr Muller’s Medical College, Mangalore. These patients were divided into two groups- Wet and Dry, based on the presence or absence of ear discharge at the time of surgery respectively. Inclusion Criteria: Patients of age group 16-60 years and both sexes, with mucosal type of chronic otitis media who underwent type 1 tympanoplasty with cortical mastoidectomy. Exclusion criteria: Patients with squamosal type of chronic otitis media or with ossicular chain erosion. A comparative analysis was done on the hearing improvement and incidence of the graft uptake postoperatively between the two groups.

Results: In dry group, complete graft uptake was seen in 90% cases, whereas in wet group, a graft uptake rate of 86.7% was achieved. The graft take up rate is better in high x socio-economic status. Higher take up rates were seen in small and medium perforation compared to subtotal perforations. Hearing improvement, assessed by mean gain of PTA at the end of 6th month postoperatively, was achieved in 86% cases in Wet group and 90% cases in Dry group. There was an average hearing improvement of 13.08 db in speech frequencies in 88.3% cases. The difference between the two groups was statistically insignificant.

Conclusions: In our study, we found no statistically significant differences between the success rates of Wet and Dry group, either in terms of graft uptake or the hearing improvement. Thus, from our study, we conclude that the presence of ear discharge at the time of surgery does not affect the success rate of type 1 tympanoplasty. 

References

Manolidis S. Closure of Tympanic Membrane Perforations. In: Gulya AJ (editor). Glasscock & Shambaugh’s Surgery of the ear. 5th ed. BC Decker; 2003: 400.

Perkins R. Grafting materials and methods in reconstructive ear surgery. Ann Otol Rhinol Laryngol. 1975; 84(4 Pt1):518-26.

Wright T. Anatomy and development of the ear and hearing. In Ludman H, Wright T (editor). Diseases of the ear. 6th ed. Amlod, London; 1998: 3-5.

Austin DF. Acoustic mechanisms in middle ear sound transfer. Otolaryngol Clin North Am. 1994;27(4):641-53.

Bluestone CD, Gates GA, Klein JO, Lim DJ, Mogi G, Ogra PL, et al. Panel report of Definitions, terminology, and classification of otitis media. Ann Otol Rhinol Laryngol. 2002;111:8-18.

Booth JB. Myringoplasty-The lessons of failure. J Laryngol Otol.1974;88:1223-36.

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

Yasuo M, Masafumi S, Yoshifumi, Takayashi, Kitahara T, Kajikawa H, Kubo T. Tympanoplasty with and without mastoidectomy for non-cholestatomatous chronic suppurative otitis media. Eur Arch Otorhinolaryngol. 2001;258(1):13-5.

Emir H, Ceylan K, Kizilkaya Z, Gocmen H, Uzunkulaoglu, Samim E. Success is a matter of experience: type 1 tympanoplasty. Eur Arch Otorhinolaryngol. 2007;264:595-9.

Krishnan A, Reddy EK, Chandrakiran C, Nalinesha KM, Jagannath PM. Tympanoplasty with and without cortical mastoidectomy-a comparative study. Indian J Otolaryngol Head Neck Surg. 2002;54(3):195-8.

Ashok KS, Munsi DM, Ghosh SN. Evaluation of improvement of hearing in type 1 tympanoplasty and its influencing factors. Indian J Otolaryngol and Head Neck Surg. 2006;58(3):253-7.

Nayak DR, Balakrishnan R, Hazarika P, Mathew PT. Role of cortical mastoidectomy in the results of myringoplasty for Dry tubotymphanicdisease. Indian J Otol. 2003;9:11-5.

Mcgrew BM, Jackson CG, Glassocck ME. Impact of mastoidectomy in simple tympanic membrane perforation repair. Laryngoscope. 2004;114(3):506-11.

Gersdorff M, Gerard JM, Thill MP. Overlay versus underlay Tympanoplasty: A comparative study of 122 cases. Rev Laryngol Otol Rhinol. 2003;124(1):15-22.

Kumar N, Shekhar C, Kumar P, Kundu AS. Kuppuswamy’s socioeconomic status scale-updating for 2007. Indian J Pediatr. 2007:l 74:1132-3.

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Published

2017-06-24

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Original Research Articles