Acta Scientific Otolaryngology (ASOL) (ISSN: 2582-5550)

Research Article Volume 4 Issue 7

A Comparative Study of Circumferential Elevation of Tympanomeatal Flap and Conventional Tympanomeatal Flap Elevation Underlay Technique in Subtotal Perforation

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

References

  1. Acuin J. “Chronic suppurative otitis media-burden of illness and management options”. Geneva: World Health Organization (2004).
  2. Manolidis S. Closure of Tympanic Membrane Perforations”. In Gulya AJ (ed): Glasscock and Shambaugh‘s Surgery of the ear. 5th BC Decker (2003): 400.
  3. Lierle DM. “Committee on Conservation of Hearing, American Academy of Ophthalmology and Otolaryngology. Standard classification for surgery of chronic ear disease”. Archives of Otology2 (1965): 204-205.
  4. Mohamed A., et al. “Functional results after myringoplasty and type I tympanoplasty with the use of different graft materials”. Journal of Medical Research Institute 26 (2006): 369-374.
  5. Verhoeff M. “Chronic suppurative otitis media: A review”. International Journal of Pediatric Otorhinolaryngology1 (2006): 1-12.
  6. Webb B and Chang CYJ. “Efficacy of Tympanoplasty without mastoidectomy for Chronic Superative Otitis Media”. Archives of Otorhinolaryngology-Head and Neck Surgery11 (2008): 1155-1158.
  7. Sarkar Saurav. “A Review on the History of Tympanoplasty”. Indian Journal of Otolaryngology and Head and Neck Surgery 65 (2013).
  8. Banzer M. “Disputatio de Auditione Laesa”. Johannis Rohrerei, Wittenbergae (1651).
  9. Toynbee J. “On the use of an artificial membrane Qmpaniin cases of deafness dependent upon perforations or destruction of the natural organ”. John Churchill and Sons, London (1853).
  10. Blake CJ. Transactions of the first congress of the international otological society”. D. Appleton and Company, New York (1887).
  11. Berthold E. “Uebermyringoplastik”. Wier Med Bull 1 (1878): 627
  12. Wullstein H. “The restoration of the function of the middle ear in chronic otitis media”. Annals of Otology, Rhinology and Laryngology 2 (1971): 210-217.
  13. Zollner F. “The principles of plastic surgery of the sound conducting apparatus”. Journal of Laryngology and Otology 69 (1955): 637.
  14. Sooy FA. “A method of repairing a large marginal perforation”. Annals of Otology, Rhinology and Laryngology 65 (1956): 911.
  15. House WF. “Myringoplasty”. Archives of Otolaryngology 71 (1960): 399-404.
  16. Plester D. “Myringoplasty methods”. Archives of Otolaryngology 78 (1963): 310-316-320.
  17. House WF andSheehy JL. “Myringoplasty: use of ear canal skin compared with other techniques”. Archives of Otolaryngology 73 (1961): 407-421.
  18. Sheehy JL and Glasscock ME. “Tympanic membrane grafting with temporalis fascia”. Archives of Otolaryngology 86 (1967): 391.
  19. Shea JJ Jr. “Vein graft closure of eardrum perforations”. Journal of Laryngology and Otology 74 (1960): 358-362.
  20. Austin DF. “Transcanal tympanoplasty”. Otolaryngologic Clinics of North America 5 (1972): 12743-12724.

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.




Metrics

Acceptance rate34%
Acceptance to publication20-30 days
Impact Factor0.871

Indexed In








News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is February 15, 2023.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of “Best Article of the Issue”.
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.
  • Contact US