ABSTRACT
Background: To study ossicular defects in cases of Chronic Suppurative Otitis Media. Study design: Retrospective. Methods: The study included 90 patients of Chronic Suppurative Otitis Media who underwent surgery in the Department of Otorhinolaryngology, Muzaffarnagar Medical College, a tertiary care centre in the state of Uttar Pradesh. The period of study was from September 2014 to August 2017. Results: The overall male: female ratio was 1:1.14. Most of the patients had bilateral disease (38.89%), followed by left ear as the only diseased ear. Malleus was involved in 11 patients, all with active squamousal disease. Incus was involved in total 21 patients (3- mucosal category, 19 – squamousal). Stapes involvement was seen in 15 patients (2-mucosal and 13-squamousal disease). Incus was involved most frequently in 21.11%; followed by stapes; involved in total 16.66% patients. Malleus was most resistant ossicle, involved in 12.22% patients. Conclusion: Malleus was the most resistant ossicle to erosion in chronic suppurative otitis media whereas incus was found to be the most susceptible. Overall, the order of ossicular involvement was incus>stapes>malleus. In active squamousal disease, stapes and malleus were equally involved.
ABSTRACT
Background: Hearing is a sense that enables man to establish contact with his fellows via speech to experience life more fully. Deafness in varying degrees of severity is a big impediment to the integration of a person into the social structure. The otologist in the past had not much to offer to hearing handicapped people with chronic middle ear disease. With recent times the advent of the antibiotic era, the operating microscope and modern anesthetics techniques aimed at producing a dry, magnified operating field, have radically altered the outlook. Methods: This Prospective Randomised Comparative Study comprises of patients who were subjected to tympanoplasty for the treatment of chronic suppurative otits media. Each patient was subjected to a detail examination of nose, paranasal sinuses and throat to rule out any focus of infection, which could influence the result of tympanoplasty. 35 Patients were subjected to tympanoplasty with temporalis fascia while the remaining 35 patients underwent with tragal perichondrium in the age group of 15-50 years (males and females both ). Patients with the complaint of discharging ear and decreased hearing were also screened . Results: Majority of the patients preoperatively showed mild to moderate hearing loss.45.7% patients showed upto 20 db air bone gap range, 48.5% patients being in 21-40db air-bone gap and only 5.7% patients is above 40db. Graft take rate was overall 78.5%. Take-rate was 80% with temporalis fascia and 77.1% with tragal perichondrium. In the postoperative hearing analysis, 75.7% of the patients showed air- bone gap upto 20dB. 21.4% of the patients showed air- bone gap in the range of 21-40 Db. Mean improvement in hearing for temporalis fascia was 12.8 db and for tragal perichondrium was 11.4 db. Take rate of graft was not influenced by the size of perforation. Improvement in hearing was also not significantly influenced by the type of graft used. Conclusion: Tympanoplasty is the most effective method for control of the tubotympanic type of CSOM disease and hearing improvement. Both temporalis fascia and tragal perichondrium are excellent graft materials for closure of perforation of tympanic membrane and hearing improvement. Graft uptake rate is good for both with slightly better take rates for temporalis fascia, than tragal perichondrium.Improvement in hearing is not significantly influenced by duration of disease, age or sex of patients site or size of perforation
ABSTRACT
Hearing loss is known to vary from place to place and country to country in both sexes with advancing age. There is scarcity of such information in India, and even no study is available from the Ghaziabad belt of North India. This prompted us to undertake a study on hearing impairment in the local population at Ghaziabad. It included three hundred persons, half of them were males and rest of the half were females. Selection of cases was done randomly. The age of the subjects ranged from 15 to 80 years, cases were divided into four groups. Only healthy subjects were selected for the study after thorough history taking and examination.Mild degree of hearing loss was observed in both men and women at middle and older age groups, percentage of males having hearing loss was more than women . Mean age ofhearing loss in women was 51.22 years and 51.55 years in men, but with advancing age further hearing loss in women takes less time than in men. With advancing age loss of hearing threshold is less in lower frequencies in men as compared to women whereas with advancing age loss of hearing threshold in higher frequencies is more in men than women , statistically the results were highly significant.