COMPARISON BETWEEN EFFICACY OF TYMPANOPLASTY WITH AND WITHOUT CORTICAL MASTOIDECTOMY IN TUBO-TYMPANIC OTITIS MEDIA IN ADULTS
DOI:
https://doi.org/10.55519/JAMC-04-13597Keywords:
keywords Mastoid, Mastoidectomy, Otitis Media, Suppurative, Tympanoplasty, ABGAbstract
Background: Chronic suppurative otitis media (CSOM) tubo-tympanic type is a common ear condition in underdeveloped nations. Cortical mastoidectomy in conjunction with tympanoplasty has long been regarded as the preferred surgical procedure for patients with chronic non-cholesteatomatous otitis media. Studies contrasting tympanoplasty with and without cortical mastoidectomy improved hearing, but the results were comparable. Both of these procedures are still debatable and mandate further research. This comparison has not been conducted in Pakistan before. Our objective is to evaluate whether tympanoplasty is effective in managing tubo-tympanic otitis media in patients with or without cortical mastoidectomy. Methods: Eighty-two patients (equally divided into two groups) were recruited from the Shaikh Zayed Hospital, Lahore. Group A (n=41) referred to tympanoplasty with mastoidectomy and group B (n=41) referred to tympanoplasty alone. Data was gathered using a pre-designed Proforma, and SPSS version 25.0 was used for analysis. Post-operative hearing improvement was calculated from the audiometric’ air-bone gap before the operation minus the ABG of post-operative follow-up at 16 weeks. A hearing gain of at least 15dB was considered clinically relevant. Results: Hearing improvement was observed in 73.3% of participants in group A while 83.3% in group B, grafting status was 95.1% in group B and 90.2% in group A, and discharge presence was 7.3% and 17% in group A and group B respectively. Conclusion: In CSOM, mastoidectomy does not add significant benefit in terms of hearing & graft uptake, however, it is advantageous if the middle ear mucosa is unhealthy. Tympanoplasty alone is sufficient if the middle ear mucosa is healthyReferences
1. Tuoheti A, Gu X, Cheng X, Zhang H. Silencing Nrf2 attenuates chronic suppurative otitis media by inhibiting pro-inflammatory cytokine secretion through up-regulating TLR4. Innate Immun 2021;27(1):70–80.
2. Singh KK, Trivedi A, Jain N, Irteza M. To Study Auditory Functions in Chronic Kidney Disease. Indian J Otol 2018;23(3):261–5.
3. Artono, Surarto B, Purnami N, Hutahaen F, Mahardhika MR. The Association of IL-1 Alpha Level and TNF Alpha Expressions on Bone Destruction in Chronic Suppurative Otitis Media and Cholesteatoma. Indian J Otolaryngol Head Neck Surg 2020;72(1):1–7.
4. Sevil E, Doblan A. Significance of the middle ear risk index in predicting tympanoplasty success in the elderly. Eur Arch Otorhinolaryngol 2021;278(10):3689–95.
5. Arístegui I, Aranguez G, Casqueiro JC, Gutiérrez-Triguero M, Del Pozo A, Arístegui M. Subtotal Petrosectomy (SP) in Cochlear Implantation (CI): A Report of 92 Cases. Audiol Res 2022;12(2):113–25.
6. Chandra Sahu M, Swain SK. Surveillance of antibiotic sensitivity pattern in chronic suppurative otitis media of an Indian teaching hospital. World J Otorhinolaryngol Head Neck Surg 2019;5(2):88–94.
7. Chong LY, Head K, Richmond P, Snelling T, Schilder AGM, Burton MJ, et al. Systemic antibiotics for chronic suppurative otitis media. Cochrane Database Syst Rev 2021;2(2):CD013052.
8. Khomtchouk KM, Kouhi A, Xia A, Bekale LA, Massa SM, Sweere JM, et al. A novel mouse model of chronic suppurative otitis media and its use in preclinical antibiotic evaluation. Sci Adv 2020;6(33):eabc1828.
9. Mahairas AD, Neff R, Craker N, McNulty BN, Shinn JB, Bush ML. Trends in Opioid Usage Following Tympanoplasty and Mastoidectomy. Otol Neurotol 2020;41(8):e1035–40.
10. Tan JQ, Chen Y Bin, Wang WH, Zhou SL, Zhou QL, Li P. Application of Enhanced Recovery After Surgery in Perioperative Period of Tympanoplasty and Mastoidectomy. Ear Nose Throat J 2021;100(10 Suppl):1045–9.
11. Aristizabal J, Puac P, Zamora C, Castillo M. Expected Findings and Complications After Tympanoplasty and Mastoidectomy. Neurographics 2019;9(3):220–30.
12. Huang J, Li Z, Wu K, Wang W. Long-term outcomes after performing tympanoplasty without mastoidectomy for active and inactive noncholesteatomatous chronic otitis media. ORL J Otorhinolaryngol Relat Spec 2018;80(5-6):277–83.
13. Parab SR, Khan MM. New Cartilage Slicer for Slicing Techniques in Tympanoplasty: Design and Applications. Indian J Otolaryngol Head Neck Surg 2018;70(4):515–20.
14. Karakuş MF, Karakurt SE, Çolak M, Dere HH. The effect of perforation size and site on graft success and hearing in Type 1 Cartilage Tympanoplasty. Middle Black Sea J Heal Sci 2020;6(3):364–8.
15. Kim H, Bae HY, Choo OS, Choung YH. Efficacy of tympanoplasty without mastoidectomy for treating chronic otitis media in patients with mastoid cavity opacification in temporal bone computed tomography findings. Clin Exp Otorhinolaryngol 2018;11(1):30–4.
16. He D, Shou Z, Hsieh Y, Wang C, Wang J, Han Z, et al. Endoscopic tympanoplasty without mastoidectomy for active mucosal chronic otitis media with mastoid and tympanic antrum lesions: A prospective clinical study. ORL J Otorhinolaryngol Relat Spec 2019;81(5–6):287–93.
17. Dave V, Ruparel M. Correlation of Eustachian Tube Dysfunction with Results of Tympanoplasty in Mucosal Type of Chronic Suppurative Otitis Media. Indian J Otolaryngol Head Neck Surg 2019;71(1):10–3.
18. Baz MR. Effect of cortical mastoidectomy on audiological outcomes in mucosal chronic otitis media. Al-Azhar Int Med J 2020;1(3):258–63.
19. Dispenza F, Mistretta A, Gullo F, Riggio F, Martines F. Surgical management of retraction pockets: Does mastoidectomy have a role? Int Arch Otorhinolaryngol 2021;25(1):12–7.
20. Kim JS, Lim IG, Oh JH, Kim BG, Chang KH. External Auditory Canal Reconstruction and Mastoid Obliteration Using Modified Palva Flap in Canal Wall Down Mastoidectomy With Tympanoplasty. Ann Otol Rhinol Laryngol 2019;128(6_suppl):69S–75.
21. Lee JY, Hong SK, Lee HJ, Lee JK, Kim HJ. Hearing Results after Type I Tympanoplasty with Versus without Mastoidectomy. Korean J Otorhinolaryngol Neck Surg 2021;64(11):785–91.
22. Shew MA, Muelleman T, Villwock M, Muelleman RJ, Sykes K, Staecker H, et al. Therapeutic Mastoidectomy Does Not Increase Postoperative Complications in the Management of the Chronic Ear. Otol Neurotol 2018;39(1):54–8.
23. Zhu XH, Zhang YL, Xue RY, Xie MY, Tang Q, Yang H. Predictors of anatomical and functional outcomes following tympanoplasty: A retrospective study of 413 procedures. Laryngoscope Investig Otolaryngol 2021;6(6):1421–8.
24. Varshney S, Nangia A, Bist SS, Singh RK, Gupta N, Bhagat S. Ossicular Chain Status in Chronic Suppurative Otitis Media in Adults. Indian J Otolaryngol Head Neck Surg 2010;62(4):421–6.
25. Agrawal A, Bhargava P. Comparative Evaluation of Tympanoplasty with or Without Mastoidectomy in Treatment of Chronic Suppurative Otitis Media Tubotympanic Type. Indian J Otolaryngol Head Neck Surg 2017;69(2):172–5.
26. McGrew BM, Jackson CG, Glasscock ME. Impact of Mastoidectomy on Simple Tympanic Membrane Perforation Repair. Laryngoscope 2004;114(3):506–11.
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