G Prabhakar¹, Darshan Gowda PV²* and Vidya³

¹Professor and Dean, Department of Otorhinolaryngology, Vydehi Institute of Medical Sciences and Research Center, Bangalore, RGUHS, India
²Post Graduate Resident, Department of Otorhinolaryngology, Vydehi Institute of Medical Sciences and Research Center, Bangalore, RGUHS, India
³Assistant Professor, Department of Otorhinolaryngology, Vydehi Institute of Medical Sciences and Research Center, Bangalore, RGUHS, India

*Corresponding Author: Darshan Gowda PV, Post Graduate Resident, Department of Otorhinolaryngology, Vydehi Institute of Medical Sciences and Research Center, Bangalore, RGUHS, India.

Received: May 17, 2022; Published: June 22, 2022

Abstract

Background: Chronic Otitis Media is defined as chronic inflammation of middle ear and mastoid cavity, which presents with recurrent ear discharge through tympanic membrane perforation. Most commonly caused by infections of middle ear, other causes are trauma and iatrogenic. Majority of the perforations are small and heal spontaneously, however; recurrent infections result in chronic perforation in which medical/conservative intervention is ineffective. Therefore, surgery i.e. Tympanoplasty is best modality of treatment. Type 1 tympanoplasty refers to repair of TM without altering the ossicular chain, includes exploration of middle ear to inspect and ensure normality of ossicles. The most commonly used graft material is temporalis fascia graft.

Objectives of Study

• Evaluation of hearing improvement in patients undergoing tympanoplasty with circumferential tympanomeatal flap elevation and conventional tympanomeatal underlay technique.
• To compare the incidence of graft uptake by circumferential tympanomeatal flap elevation and conventional tympanomeatal underlay technique.
• To study the incidence of post operative complications if any in both groups

Methods: 90 patients presenting with Chronic Otitis Media in ENT OPD at Vydehi Institute of Medical Sciences and Research Centre, Bangalore. Preoperative audiometry was documented. All 90 patients underwent type 1 Tympanoplasty. post operative audiometry and graft uptake. And the outcome of results of tympanoplasty with circumferential tympanomeatal flap elevation and conventional tympanomeatal underlay technique

Results: Our study revealed that type 1 tympanoplasty had equal success rates i.e. 95.6% patients in circumferential TM flap elevation technique group and 91.1% in conventional TM flap elevation technique group, in terms of graft up take and hearing improvement i.e., Hearing gain of more than 10 dB group was seen in 37 patients, 17 (37.8%) in conventional TM flap group and 20 (44.4%) in circumferential TM flap group. Hearing gain of less than 10 dB group was seen in 53 patients, 28 (62.2%) in conventional TM flap group and 25 (55.6%) in circumferential TM flap group. Most of the patients in both the groups had nil post- operative complications.

Conclusion: Taking into account the observations of our study and weigh against with similar studies we conclude that there will be equal success rates, in terms of graft up take and hearing improvement, whether it is conventional tympanomeatal flap elevation technique or circumferential tympanomeatal flap elevation technique underlay technique in subtotal perforation. The results of this study benefits the surgeon to make a choice to operate with conventional tympanomeatal flap elevation technique to get an equally prosperous result as comparable to circumferential tympanomeatal flap elevation technique.

Keywords: Chronic Otitis Media; Tympanoplasty; Temporalis Fascia Graft; Audiometry

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Citation

Citation: Darshan Gowda PV., et al. “A Comparative Study of Circumferential Elevation of Tympanomeatal Flap and Conventional Tympanomeatal Flap Elevation Underlay Technique in Subtotal Perforation".Acta Scientific Otolaryngology 4.7 (2022): 70-79.

Copyright

Copyright: © 2022 Darshan Gowda PV., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.