<p class="abstract"><strong>Background:</strong> Ossiculoplasty for ossicualar disruption in patients of chronic otitis media (COM) can be done by using either bone or cartilage. The present study was planned to compare bone and cartilage ossiculoplasty in patients of ossicular disruption due to COM.</p><p class="abstract"><strong>Methods:</strong> The prospective observational study was carried out in patients, who were admitted in the department of otorhinolaryngology of a tertiary care teaching hospital of Rajasthan during two years from November 2017 to November 2019. All patients with ossicular disruption due to COM and conductive hearing loss more than 40db were included in the study. Patients with sensorineural hearing loss were excluded from the study. Pure tone audiometry (PTA) was done before surgery. Hearing improvement was assessed 3, 6 and 12 months after surgery. </p><p class="abstract"><strong>Results:</strong> In the present study 20 patients underwent bone ossiculoplasty using autologous incus and autologous cartilage was used in 80 patients for ossiculoplasty. Post-operative hearing gain was significantly more in autologous incus patients (22.7±4.2 db) compared to autologous cartilage (19.5±3.4 db) (p=0.002).</p><p><strong>Conclusions:</strong> The present study concluded that post-operative hearing gain was significantly better with autologous incus compared to autologous cartilage although both showed good results in terms of hearing gain. </p>
<p><strong>Background:</strong> Objectives were to compare outcomes, intra operative visualization and operative time duration in endoscopic assisted vs conventional middle ear and mastoid surgery.</p><p><strong>Methods: </strong>This prospective comparative study was conducted in 50 patients; among them 25 cases were of endoscope assisted middle ear surgery and 25 cases with conventional microscopic middle ear surgery. A 4 mm diameter, 18 cm long rigid, zero-degree endoscope and operating microscope was used. Primary outcomes include mean average pre and post operative air-bone (A-B) gap, hearing thresholds, intra operative visualization and duration of surgery.<strong></strong></p><p><strong>Results: </strong>Mean A-B gap closure for endoscopic assisted tympanoplasty was 12.76±6.00 dB, while it was 8.38±5.78 dB for non-endoscopic assisted tympanoplasty. The results were comparative. Mean intra-operative time duration for endoscopic assisted tympanoplasty was 70.23±4.17 min, while it was 77±9.80 min for non-endoscopic assisted tympanoplasty with statically significant difference between both groups (p=0.03). Graft uptake rate for endoscopic assisted tympanoplasty was 92.31% while it was 84.62% for non-endoscopic assisted tympanoplasty. Residual cholesteatoma remnant on endoscopy was found in 43.66% cases out of 12 mastoidectomy cases performed via endoscopic assistance.<strong></strong></p><p><strong>Conclusions: </strong>The endoscope can be successfully applied to ear surgery for most of the ear procedures with a reasonable success rate both in terms of perforation closure and hearing improvement and with minimal exposure. Wide-field zero, 30 or 70° endoscope sallow visualization of hidden anatomic spaces and working around corners i.e., epitympanum, hypotympanum and retro tympanum for safe removal of cholesteatoma.</p>
Objective: The objective of the study is to compare circumferential versus anterior tucking underlay tympanoplasty technique. Methods: In this prospective observational study, 100 patients with chronic otitis media (Inactive mucosal type) were included, who were randomly allocated in two groups; Group I which comprised of 50 patients in which tympanoplasty with anterior tucking was done, and Group II comprised of 50 patients in which circumferential flap tympanoplasty was done. Improvement in the hearing gain and graft uptake success rate was compared. Results: The mean air-bone gap (ABG) changed from 28.74 dB to 11.52 dB after anterior tucking with a mean change of 17.22 dB and this change was found to be statistically significant (p<0.001). Similarly, the mean ABG changed from 28.92 dB to 11.86 dB after a circumferential flap with a mean change of 17.06 dB and this change was also found to be statistically significant (p<0.001). There was a slightly better improvement (17.22 dB) in the anterior tucking group as compared to the circumferential flap (17.06 dB). This difference was, however, not found to be statistically significant (p=0.830). Three-month graft uptake rate in the anterior tucking group was found 92% and in the circumferential group was 94%. (p>0.05). Conclusions: Our study concluded that both techniques have almost the same results with good graft uptake. Results of hearing improvements in both techniques were also comparable.
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