A Comparative Study on Effect of Different Approaches of Mastoidectomy
Related to Recurrence and Hearing Improvement
Sushil G Jha1 and S Balaji2*
1HOD, Department of ENT, Government Medical College, Bhavnagar Gujarat, India
2Former Resident, Department of ENT, Government Medical College Bhavnagar and
Meenakshi Mission Hospital and Research Centre, Madurai, Tamilnadu, India
*Corresponding Author: S Balaji, Former Resident, Department of ENT,
Government Medical College Bhavnagar and Meenakshi Mission Hospital and
Research Centre, Madurai, Tamilnadu, India.
January 26, 2022; Published: February 28, 2022
Introduction: Hearing can be impaired by many conditions such as congenital, or due to trauma or infection or any abnormality in
conductive pathway, of this infection in middle ear is one of the most common cause of hearing loss in developing countries. So any
abnormality in tympanic membrane or middle ear conductive mechanism may cause Conductive type of hearing loss.
The diagnosis of chronic otitis media (COM) implies a permanent abnormality of the pars tensa or flaccida, most likely a result of
earlier acute otitis media, negative middle ear pressure or otitis media with effusion.
Materials and Methods: A comparative retrospective study was conducted on the patients of unsafe type of chronic otitis media,
who had undergone mastoid surgery.
Aim: Aim of this study is to compare the success rate of the different types of mastoid surgeries like modified radical mastoidectomy
(canal wall down), intact canal wall mastoidectomy without posterior tympanotomy and intact canal wall mastoidectomy with posterior
tympanotomy, in terms of eliminating cholesteatoma and to assess the postoperative hearing improvement in different kinds
Inclusion criteria: Patients having unsafe type of COM.
Exclusion criteria: Patients who were excluded for intact canal wall surgery were,
• Revision ICW cases
• More than 1/3rd destruction of posterior canal wall (Intra operative finding) 3.Patients who had severe to profound hearing loss
Conclusion: Intact canal wall masotidectomy with or without posterior tympanotomy were having better hearing results compared
to modified radical mastoidectomy. The advantage of intact canal wall mastoidectomy with posterior tympanotomy are, minimal recurrence
rate due to completely removal of disease, and better post op hearing threshold. But intact canal wall mastoidectomy with
posterior tympanotomy is technically difficult, it requires good surgical skills. Modified radical mastoidectomy has inherent cavity
problem, poor post op hearing as reconstruction with auto graft is difficult and requires lifelong follow up but has the advantage of
less recurrence and technically easy to perform. In Intact canal wall mastoidectomy without posterior tympanotomy can give good
hearing results as it allows hearing reconstruction and also offers a greater selection of hearing aids but complete eradication of
disease might not be possible.
Keywords: Hearing; Chronic Otitis Media; Diagnosis
- Aleem Abdul., et al. “Emerging Variants of SARS-CoV-2 And Novel Therapeutics Against Coronavirus (COVID-19)”. Stat Pearls, Stat Pearls Publishing, 5 (2022).
- Umashankar A., et al. "Sudden Sensorineural Hearing Loss Post Coronavirus Disease: A Systematic Review of Case Reports”. Indian Journal of Otolaryngology and Head and Neck Surgery (2021).
- Wiersinga WJ., et al. "Pathophysiology, Transmission, Diagnosis, and Treatment of Coronavirus Disease 2019 (COVID-19): A Review”. JAMA - Journal of the American Medical Association8 (2020): 782-793.
- Babini D., et al. "Neurological findings, sensory changes in the olfactory, taste and auditory function in patients with Covid-19: a literary review". Electronic Journal Collection Health 46 (2020): 1-8.
- Mustafa MWM. "Audiological profile of asymptomatic Covid-19 PCR-positive cases”. American Journal of Otolaryngology - Head and Neck Medicine and Surgery3 (2020): 102483.
- Costa-Guarisco LP., et al. "Percepção da perda auditiva: Utilização da escala subjetiva de faces para triagem auditiva em idosos”. Ciencia e Saude Coletiva11 (2017): 3579-3588.
- Johnson Marsha. "A Tool for Measuring Hyperacusis”. The Hearing Journal3 (1999): 34-35.
- Jerger J., et al. "A new approach to speech audiometry”. Journal of Speech and Hearing Disorders 33 (1968): 318-328.
- Iannella G., et al. "Impact of COVID-19 pandemic on the incidence of otitis media with effusion in adults and children: a multicenter study”. European Archives of Oto-Rhino-Laryngology (2021): 0123456789.
- Raad N., et al. "Otitis media in coronavirus disease 2019: A case series”. Journal of Laryngology and Otology1 (2021): 10-13.
- Saniasiaya J and Kulasegarah J. "Dizziness and COVID-19”. Ear, Nose and Throat Journal1 (2021): 29-30.
- Viola P., et al. "Tinnitus and equilibrium disorders in COVID-19 patients: preliminary results". European Archives of Oto-Rhino-Laryngology10 (2021): 3725-3730.
- Karimi-Galougahi M., et al. "Vertigo and hearing loss during the covid-19 pandemic – is there an association? "Acta Otorhinolaryngologica Italica6 (2020): 463-465.
- De Luca P., et al. "Auditory Disturbances and SARS-CoV-2 Infection: Brain Inflammation or Cochlear Affection? Systematic Review and Discussion of Potential Pathogenesis”. Frontiers in Neurology 12 (2021): 1-9.
- Ribeiro AEFC. "Pesquisa do limiar de desconforto auditivo em pacientes com hipersensibilidade auditive 19.2 (2007): 181-192.
- Coey JG and De Jesus O. "Hyperacusis”. In: Stat Pearls. Treasure Island (FL): Stat Pearls Publishing; (2021).
- Silva Tagda and Barbosa JSL. "Distúrbio do processamento auditivo central: a importância do diagnóstico precoce para o desenvolvimento da criança”. 10 Encontro Internacional de Formação de Professores e 11 Fórum Permanente Internacional de Inovação Educacional (2016): 1-16.
- Trecca E., et al. "COVID-19 and hearing difficulties”. American Journal of Otolaryngology 41 (2020).
- Hulzen R and Fabry D. "Impact of Hearing Loss and Universal Face Masking in the COVID-19 Era”. Mayo Clinic Proceedings10 (2020): 2069-2072.
- Sanguebuche TR., et al. "Behavioral tests in adults: reference values and comparison between groups presenting or not central auditory processing disorder”. Revista CEFAC1 (2020): 1-10.
- Miri SM and Ajalloueyan M. "Critical Alert for Otolaryngologists: Earache May be the Early Signs of COVID-19”. Iranian Red Crescent Medical Journal5 (2020).
- Buzo BC., et al. "Reconhecimento de fala no ruído em sujeitos com audição normal e queixa de zumbido TT - Speech recognition in noise in individuals with normal hearing and tinnitus”. Audiology - Communication Research (2017): 1-7.
- Ribeiro GE and Silva DPCDA. "Audiological implications of COVID-19: an integrative literature review”. Revista CEFAC1 (2021): 1-7.
- Satar B. "Criteria for establishing an association between Covid-19 and hearing loss”. American Journal of Otolaryngology6 (2020).