Pre-operative evaluation of chronic suppurative otitis media tubotympanic disease otomicroscopy versus otoendoscopy: a comparative and correlative study.

Sarin Kaushal, Z (2007) Pre-operative evaluation of chronic suppurative otitis media tubotympanic disease otomicroscopy versus otoendoscopy: a comparative and correlative study. Masters thesis, Christian Medical College, Vellore.


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Chronic Suppurative Otitis Media, tubotympanic disease remains one of the commonest conditions in India that an ENT surgeon is faced with in his routine practice. Though life threatening complications associated with this condition are rare, other conditions such as recurrent discharge despite treatment, residual perforation, worsening hearing, graft failure, etc are not uncommon. For these reasons complete and meticulous evaluation of the patient is very important. The introduction of the binocular operating microscope was a landmark event in the development of modern otology, and it clearly changed the scope and character of ear surgery. Despite continuous technical improvements, the basic optical principles, and their limitations have stayed the same over the last three decades. With the introduction of the endoscope into other branches of surgery, there have been attempts at its utilization in otology. The diagnostic, mostly photographic, role of the endoscope for examining the tympanic membrane and the ear canal has been widely publicized. Transtympanic middle ear endoscopy was initially reported by Nomura and Takahashi et al. Poe and Bottri described transtympanic endoscopy for the confirmation of perilymphatic fistula, as well as the identification of other middle ear disorders. McKennan described second look endoscopic inspection of mastoid cavities through a small postauricular incision. Thomasin et al reported operative ear endoscopy for mastoid cavities and designed an instrument set to be used in these settings. Tarabichi reported that endoscopes offer greatest technical advantage in tympanoplasty and cholesteatoma surgery. Otomicroscopy is well established for evaluation of structural abnormalities of external auditory canal, tympanic membrane and malleus. However it is inadequate for complete evaluation of middle ear structures as incus, stapes, incudostapedial joint, eustachian tube orifice, protympanum, hypotympanum, and sinus tympani. Otoendoscopy is superior and valuable as a diagnostic tool in assessing - the Incus and Stapes, - the Incudostapedial joint, - the ossicular chain mobility, - middle ear mucosa, as well as evaluating the hidden areas of middle ear such as eustachian tube area, protympanum, hypotympanum, sinus tympanum and detecting middle ear tympanosclerosis, hidden cholesteatoma etc that can be missed by microscopy. Pre-operative otoendoscopic work up is recommended for complete evaluation of patients with Chronic Suppurative Otitis Media-tubotympanic disease

Item Type: Thesis (Masters)
Uncontrolled Keywords: Pre-operative evaluation; chronic suppurative otitis media; tubotympanic disease; otomicroscopy; otoendoscopy; comparative study
Subjects: MEDICAL > Otolaryngology
Depositing User: Devi S
Date Deposited: 11 Jul 2017 06:23
Last Modified: 11 Jul 2017 06:23

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