ABSTRACT
Background:The revision myringoplasty surgery is done for the graft failure after myringoplasty. The surgeons’ make use of the temporalis fascia or cartilage as the graft material. Some surgeons opt for the revision myringoplasty with cortical mastoidectomy as well.Methods:This study is a retrospective, observational study done in the Department of ENT and Head and Neck Surgery, Tribhuvan University Teaching Hospital from December 2015 to 2019. Dataof all the patients undergoing revision myringoplasty with or without cortical mastoidectomy were collected from the record section and included in the study. Post-operatively, the patients were assessed for graft uptake and hearing assessment after six weeks of surgery. Total uptake of the graft was taken as the successful graft uptake. The hearing was assessed by air conduction threshold (AC threshold) and air-bone gap status postoperatively.Results:Total of 42 patients were analysed with the graft uptake of 86%. There was no significant difference in the graft uptake on using the temporalis fascia or tragal cartilage. Regarding the hearing assessment, the average pre-operative and post-operative AC threshold was 37.95±5.68 dB and 29.36±6.28dB. The average pre and postoperative AB gap was 29.97±8.16dB and 21.85±6.68dB. The improvement in the hearing threshold was significant (p value<0.05).Conclusions:The graft uptake rate for revision surgery in our centre was comparable to other studies in the literature. There was significant hearing improvement pre and postoperatively after revision myringoplasty.
ABSTRACT
Introduction:Chronic suppurative otitis media (COM), mucosal variety is defined as a chronic inflammation of the middle ear and mastoid cavity, which presents with recurrent ear discharges or otorrhoea through a tympanic perforation. Aims:To find out the incidence of chronic otitis media with respect to age and sex in the study population and to compare the graft up-take rate, the graft failure rate, the rate of residual perforation and the degree of hearing improvement between the two modalities of treatment of type 1 tympanoplasty with cortical mastoidectomy and type 1 tympanoplasty aloone. Methods:The 80 patients were randomly divided into two equal groups with 40 patients undergoing type 1 tympanoplasty with cortical mastoidectomy (group A) and 40 patients undergoing type 1 tympanoplasty (Group B). Post operatively all the patients were followed up for a total of 6 months with weakly intervals on 1st month; bi weekly on 2nd month; monthly on 3rd and 6th month. Post operatively all the study patients were assessed for the status of the graft; mobility, rejection or residual perforation of the graft and the hearing improvement.ConclusionIn successful graft take up, results of hearing improvement is better in Tympanoplasty with cortical mastoidectomy than with Tympanoplasty alone. Possibility of finding mastoid antral pathology is more in patients having Chronic otitis media (mucosal) with sub total perforation as observed in this study
ABSTRACT
Background: In treatment of mucosal type of Chronic, suppurative otitis media, even well experienced otologists, remain divided in terms of combining mastoidectomy with tympanoplasty. Here we evaluate the surgical outcomes of tympanoplasties with and without cortical mastoidectomy and discuss the various pre-operative factors and post-operative subjective functional benefit of the patient. Aim: To evaluate the surgical outcomes of tympanoplasties with and without mastoidectomies in terms of graft uptake and hearing improvement. Study design: Prospective study. Methods: A total of 67 patients undergoing tympanoplasties with and without mastoidectomy were included and followed up for a period of one year. Statistical Analysis: Chi square test. Results: There was no significant difference in the surgical outcomes of both the surgeries in terms of graft uptake and hearing improvement. In unilateral cases Belfast rule of thumb application enables the actual hearing benefit of the patient. Conclusion: The addition of cortical mastoidectomy to tympanoplasty did not improve the outcome of surgeries done for mucosal type of chronic suppurative otitis media.