Effect of Type 1 Tympanoplasty on the Quality of Life of CSOM Patients

Abstract

Chronic suppurative otitis media (CSOM) continues to be an important public health problem despite significant advances in medical science. Ear discharge, pain, discomfort, difficulty in hearing, limitation of routine activities and emotional problems due to CSOM cause a significant impact on the health and general well being of the patient. We have done Type 1 tympanoplasty in tubotympanic type of COM to reconstruct the tympanic membrane and alleviate the symptoms of the patients. This study presents an analysis of the impact of the surgery on the patient subjectively and its correlation with objective outcomes. 45 patients were selected to fill the chronic otitis media-5 (COM-5) questionnaire and underwent pure tone audiometry preoperatively. All the patients underwent Type 1 tympanoplasty by using temporalis fascia graft. The status of the ossicles was checked and documented intraoperatively. Patients requiring ossicular reconstruction or with attico antral disease were excluded. Patients were followed up for a period of 6 months and those with an intact graft after 6 months were included in the study. These patients were again made to fill the questionnaire and undergo pure tone audiometry postoperatively. 37 out of 45 patients (82 %) had an intact graft 6 months after surgery. Marked improvement was observed in subjective scores as documented by the questionnaire, pre-and postoperatively with the mean improvement in total scores being 7.89 ± 4.81 on a Visual Analogue Scale. Also significant improvement was achieved in closure of air-bone gap with the mean improvement being 14.73 ± 8.58 dB. Significant correlation was found between subjective and objective scores in most patients. This study showed that Type 1 tympanoplasty brings about a significant improvement in the quality of life of chronic suppurative otitis media patients. Most patients showed a marked improvement in subjective scores which correlated well with the objective findings of the status of the graft and improvement in air-bone gap. Asymptomatic patients with less preoperative scores showed less improvement in subjective scores which did not correlate with the objective outcomes.

Endoscopic versus microscopic type 1 tympanoplasty in chronic suppurative otitis media- tubotympanic type

“…19 In Satyawati et al study the success rate regarding perforation closure was 91.5%, Bhatia et al showed 82% graft uptake, Yadav et al accounting for an 80% success rate. 20,21 In Anoop et al study, in the endoscopic group, there was 90% uptake of graft and in microscopic group it was 85%. 17 In Thirumaran et al study, the graft uptake rate was 93.3% in the endoscopic group, whereas it was 90% in the microscopic group.…”

Evaluating Success of Surgery in Mucosal and Squamosal Chronic Otitis Media: A Retrospective Study

“…Batni et al documented 88% success rate of type I tympanoplasty, Bhatia et al claimed it to be 82%, for Onal et al it was 71%. 8,10,11 Callioglu et al reported 89.5% successful graft uptake in their study. 12 The rate of surgical success-integration of the graft -was 93.3% as stated by Naderpour et al 6 Kamath et al documented successful uptake of graft post type I tympanoplasty to be 80%.…”

Postoperative Outcomes After Tympanoplasty for Active Versus Inactive Otitis Media Patients With Tympanic Membrane Perforation: A Systematic Review and Meta-Analysis

“…We assessed 221 full texts for eligibility as 18 were not able to be retrieved, of which we excluded 188 references. We included 33 studies (8–40) in the systematic review with full details available in a separate table [Supplementary Content 3, http://links.lww.com/MAO/B681], of which seven studies with similar study design (7–13) were included for the meta-analysis. A flowchart of the number of articles included or excluded at each stage is available in Figure 1.…”

“…Twenty studies (60.6%) were undertaken in India, three studies (9.1%) in China, two studies (6.1%) each in Thailand and Bangladesh, and one study (3.0%) each in Korea, Nepal, Iraq, Italy, Egypt, and Pakistan. In terms of study design, 13 studies (11,19,20,(24)(25)(26)(27)(28)(29)(30)(31)(32)(33) were randomized and 20 (7)(8)(9)(10)12,13,18,21,22,(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44) were nonrandomized. The inclusion and exclusion criteria of all studies are summarized in Supplementary Content 3, http://links.…”

“…Patient ages ranged from 15 to 60 years old. 23 studies recruited patients with dry ear status (11,(18)(19)(20)(21)(22)(24)(25)(26)(27)(28)(29)(31)(32)(33)35,36,(38)(39)(40)(42)(43)(44), three studies with wet ear status (30,34,37), and 7 studies with both dry and wet ear status (7)(8)(9)(10)12,13,41). Some studies only included microscopic myringoplasty (7-10, 12,13,18-21,24,26,31-33,35,37,40-42), some only endoscopic myringoplasty (27,28,30,34,38,44) and some included both types (11,19,20,(24)(25)(26)(27)(28)(29)…”