ABSTRACT
Abstract Objectives: Analyze the prevalence of retractions in different areas of the Tympanic Membrane (TM), the correlations between the involvement of the Pars Tensa (PT) and Pars Flaccida (PF), and the air-bone gaps. Methods: A cross-sectional study. Patients with moderate and/or severe TM retraction of 2200 consecutive patients with chronic otitis media between August 2000 and January 2019 were included. Ears with previous surgery were excluded. Ears were classified as isolated PF and PT retractions and association of both. The degrees of severity and presence of effusion were evaluated. The data were analyzed using the SPSS Statistics software program. Results: 661 ears were included. The prevalence of isolated atical retractions was 24.9%, of isolated posterior quadrants was 10.6%, and of association of quadrants was 64%. There was no correlation between the retractions in the different areas of the TM (posterior and attic quadrants: r = 0.13; p = 0.041; anterior and posterior quadrants: r = 0.23; p = 0.013, anterior and attic quadrants: r = 0.06; p = 0.043). Effusion was present in 30.7% of the ears. ABG median was lower in ears with PF retraction (6.25 dB HL) than PT retraction, isolated (15 dB HL) or not (13.75 dB HL; p < 0.05); 72% of the ears had an ABG ≤ 20dB HL. For severity of the retraction of PF, the ABG was similar across groups. For the PT, there was a global difference in the medians of ABG in terms of the degree of severity, with a moderate correlation. Conclusion: The prevalence of moderate and severe retractions was 24.5%; 64% of the ears had an association of affected regions. There was no correlation between the retraction in the different areas of the TM. We found a significant correlation between the severity of retraction and the worsening of ABG threshold, only for PT. Evidence level: 4.
ABSTRACT
Introduction: Adhesive otitis media is a type of chronic otitismedia, the development of which is essentially influenced bydisturbed ventilation of the middle ear. Anatomic and someother predisposing factors may play a part in the origin ofthis disease. Study aimed to find the efficacy and outcome ofcartilage tympanoplasty in patients with grade 3 and 4 parastensa retraction. (atelectatic and adhesive otitis media).Material and Methods: This study was conducted in thedepartment of ENT and HNS Govt Medical College Srinagar.A total of 25 patients with grade3 and 4 retraction wereincluded in this study. In all patients otoscopic examination,Pure Tone audiometry (PTA), impedance audiometry andoto-endoscopic examination / EUM (Examination underMicroscope) was done. Proper consent was taken from allpatients included in this study.Results: Cartilage Tympanoplasty is an effective method oftreating grade3 and 4 parastensa retraction in adhesive otitismedia patients. In our study we found less recurrence ofadhesion at 9 months followup with better compliance andimprovement in hearing. Out of 25 patients, 23 (92%) patientshad intact tympanic membrane, better hearing outcome at9 months follow-up. However in 2(8%) patients, amongthem one had displaced cartilage, another had no hearingimprovement at 9 months follow up.Conclusion: Cartilage tympanoplasty is a better surgicaloption for treating atelectatic and adhesive otitis media,with better outcome of hearing, patient compliance and lessfailure rate in terms of recurrence of disease7. Cartilage usedas reconstruction gives good tensile strength and preventsrecurrence of disease in terms of retraction