Ossicular Erosion in CSOM, Reconstructive Procedures and Outcome

Pratheesh, M C (2015) Ossicular Erosion in CSOM, Reconstructive Procedures and Outcome. Masters thesis, Tirunelveli Medical College, Tirunelveli.


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BACKGROUND: CSOM cases are quite common in India. Daily we encounter numerous cases of CSOM in our outpatient department. During the surgical management of CSOM cases, we commonly come across different types of tympanic membrane perforation, ossicular defects as peroperative findings, different ossiculoplasty methods and postop audiological outcome. So I have selected this as my dissertation topic AIMS & OBJECTIVES: 1. To find the incidence of ossicular erosion in csom (mucosal and squamous). 2. To find the incidence of ossicular erosion with respect to each type of perforation of tympanic membrane. 3. To find the incidence of various type of perforation in cases of tubotympanic type of csom. 4. To study ossicular reconstructive procedures and its audiological outcome. 5. To use MERI score & OOPS index in csom cases and analyze the surgical outcome. MATERIALS AND METHODS: This was a prospective study, conducted in department of otorhinolaryngology, Tirunelveli medical college hospital, Tirunelveli, carried out during March 2013 to September 2014. Patients prepared for surgical management for chronic uppurative otitis media in the department of otorhinolaryngology, Tirunelveli Medical College Hospital, Tirunelveli during this study period 164 such patients are included in my study. The ears were examined by otoscopy initially and otoendoscope to establish a preoperative diagnosis of safe or unsafe disease. Per operatively, tympanic membrane findings and middle ear findings like granulations, ossicle status, ossicular mobility, middle ear mucosa, Eustachian tube, etc were noted. ossiculoplasty methods were noted and documented. Follow up otoscopic and audiological evaluation and documentation was done RESULT: Of 164 patients, 40.9% were males and 59.1% were females. 39% had right ear affected where as 40.9% had left ear affected. 20.1% presented with B/L CSOM. 90.85% cases were csom mucosal type and 6.09% were csom Squamous type. Among mucosal type, subtotal presentation was the most common presentation (43.2%). Incus (24.4%) was the most common ossicle found to be eroded. Erosion of ossicles were more common in squamous type. Cortical mastoidectomy with type 1 tympanoplasty was found to be the most common surgical management done in this study. It showed a mean improvement of hearing of 11.30db. In follow up, 86% cases had graft uptake and thus a successful surgery CONCLUSION: Incus is the most common ossicle to erode in csom cases. Csom squamous type causes more chances of ossicular erosion. Prevalence of csom mucosal type is more than squamous type. Subtotal perforation is the most common presentation in csom mucosal. ossicle erosion is more probable in cases with high MERI and OOPSI score.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Csom ; ossicles ; ossiculoplasty ; malleus ; incus ; stapes ; myringoplasty ; mastoidectomy ; tympanic membrane ; tympanoplasty ; audiogram.
Subjects: MEDICAL > Otolaryngology
Depositing User: Devi S
Date Deposited: 07 Oct 2018 07:49
Last Modified: 07 Oct 2018 07:49
URI: http://repository-tnmgrmu.ac.in/id/eprint/9734

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