A Comprehensive study on Cartilage Tympanoplasty in Adhesive Otitis Media

Saravana Selvan, V (2013) A Comprehensive study on Cartilage Tympanoplasty in Adhesive Otitis Media. Masters thesis, Madras Medical College, Chennai.


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INTRODUCTION: The management of the atelectatic ear continues to be one of the most controversial issues facing the otolaryngologist. Much of the confusion associated with this disorder stems from a poor understanding of the underlying pathophysiologic conditions that ultimately lead to changes in the tympanic membrane, resulting in atrophy, diffuse or local retractions, and cholesteatoma formation. Likewise, the lack of an accepted classification or grading scheme for the atelectatic ear has made it difficult to elucidate and predict the natural history of this disease and effectively predict those cases that will ultimately develop complications, such as cholesteatoma. The controversy is augmented by the fact that, early in the course of the disease, and even in the presence of incus erosion, hearing loss is frequently minimal and the patient, for the most part, asymptomatic. OBJECTIVE: The surgical management of adhesive otitis media is debatable. Adhesive otitis media progressing to cholesteatoma cannot be predicted, and hearing remains normal until later in the disease course. Hence surgery is done only when there is a hearing loss or frank cholesteatoma develops, where an extensive surgery may be needed. Earlier intervention is often avoided due to near normal hearing levels at this stage in some cases. Hearing results who have undergone cartilage tympanoplasty with or without ossicular reconstruction are reported for patients with adhesive otitis media. Study design: This is a prospective study. Setting: Study was done at Madras Medical College and Rajiv Gandhi Govt General Hospital, Chennai-3. Patients: A total of 30 patients (31 ears) aged 13-48 years underwent cartilage tympanoplasty with or without ossicular reconstruction. Interventions: Tympanotomy followed by cartilage reconstruction of the tympanic membrane, with ossicular reconstruction if there is any ossicular discontinuity. Main Outcome Measure(s): Post-operative pure tone average, air-bone gap for 3 frequencies (500, 1000, 2000 Hz) compared to pre-operative levels. RESULTS: There was a statistically significant improvement in hearing. CONCLUSIONS: Management of adhesive otitis media with cartilage perichondrium tympanoplasty with or without ossiculoplasty is a proven modality of treatment with successful results. Cartilage gives a tensile strength to the tympanic membrane which prevents further retractions inspite of the continuing Eustachian tube dysfunction and thus prevents cholesteatoma formation without compromising on hearing.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Cartilage Tympanoplasty, Adhesive Otitis Media, Comprehensive study.
Subjects: MEDICAL > Otolaryngology
Depositing User: Devi S
Date Deposited: 25 Mar 2020 17:19
Last Modified: 25 Mar 2020 17:19
URI: http://repository-tnmgrmu.ac.in/id/eprint/12466

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