Evaluation of Eustachian tube function in chronic suppurative otitis media (tubotympanic type) with reference to its treatment outcome

Abstract

in perforated tympanic membrane and William's test is an essential tool to assess the ETF in intact tympanic membrane. Our present study is undertaken to assess the ETF in patient with CSOM with reference to its treatment outcome. Based on impedance audiometry fi ndings, patients of tubotympanic disease are categorized as totally impaired, partially impaired, and normal ETF. Patients with normal ETF were taken up for myringoplasty. Patients with totally impaired ETF irrespective of middle ear mucosal status (dry or wet) were taken up for cortical mastoidectomy with tympanoplasty. Patients with partially impaired ETF, with dry middle ear mucosa were taken up for myringoplasty and those with wet middle ear were taken up for cortical mastoidectomy with tympanoplasty. ABSTRACT Aims and Objectives:To assess the eustachian tube function (ETF) and to evaluate the treatment outcome of chronic suppurative otitis media (CSOMtubotympanic type) in relation to eustachian tube dysfunction. Materials and Methods: Prospective study for a period of 2 years; the study comprises of 100 patients diagnosed to have CSOM (tubotympanic type). ETF was assessed by Toynbee's test. Patients with normal ETF were taken up for myringoplasty. Patients with totally impaired ETF irrespective of middle ear mucosal status (dry or wet) were taken up for cortical mastoidectomy with tympanoplasty. Patients with partially impaired ETF, with dry middle ear mucosa were taken up for myringoplasty and those with wet middle ear were taken up for cortical mastoidectomy with tympanoplasty. Results and Analysis: The ETF in these patients was analyzed and graft uptake was assessed clinically in reference to ETF status. The results are tabulated and analyzed using Chi-square test using number cruncher statistical system (NCSS) software. In our study, preoperative ETF had a highly signifi cant P value0.0005. Conclusion: Methodology of treatment adapted for CSOM patients based on ETF proves that the eustachian tube plays a major role in the uptake of graft.

Evaluation of eustachian tube function in chronic suppurative otitis media with reference to its treatment outcome

“…100% success rate was seen in normal ETF, 98% in partially impaired ETF, and 76% in grossly impaired ETF. 8 Our results also correlates with Cohn et al who assessed ETF by using impedence audiometry (Toynbees test). In their study those with normal ETF, showed a graft uptake of 95%, 75% in partially impaired ETF and 69% graft uptake in totally impaired ETF.…”

Role of Impedance Audiometry in Evaluation of Eustachian Tube Function and Its Correlation with Tympanoplasty Surgery Outcome: Our Experience

“…The results of present study are comparable with Mackinnon (19) who observed 81% success rate in patients with normal ETF and 40% in patients with impaired ETF. Study results were compared with other studies in table No 3 (20)(21)(22)(23)(24). After applying the tests of significance it was found that there is no significant association between Eustachian tube function and successful graft take up (P > 0.05).…”

Relationship between Eustachian tube function and location of the perforation in chronic otitis media

“…The varying topography of the perforation would thus influence the integrity of the mucociliary system, or also the better or worse condition of the latter would influence the appearance of one type of perforation, or another. [16] Priya et al [7] did ETF by Toynbee test with impedance audiometer in tubotympanic type of chronic otitis media. They found dysfunction in 76% cases (gross dysfunction in 17% cases and partial dysfunction in 59% cases).…”

“…[6] It might therefore be possible to predict postoperative results such as hearing improvement and disease recurrence, and to choose optimal operative methods like tympanostomy tube insertion, tympanoplasty, cortical mastoidectomy etc., if ETF can be assessed preoperatively. [7] Assessment of ETF is of paramount importance not only before undertaking any surgery for suppurative otitis media but also in establishing its etiological basis.…”