Lekshmy, R Kurup (2013) A study to find out the efficacy of cortical mastoidectomy with myringoplasty in chronic suppurative otitis media. Masters thesis, Kilpauk Medical College, Chennai.
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Abstract
WHO (World Health Organization) defines chronic suppurative otitis media as a stage in ear disease in which there is a chronic infection of the middle ear cleft in the presence of persistent tympanic membrane perforation[1]. Chronic suppurative otitis media is typically a persistent disease, insidious in onset, often capable of causing severe destruction and irreversible sequelae and clinically manifests with deafness and discharge. According to Mawson’s textbook of Ear disease, it is persistent otorrhea through a non-intact tympanic membrane[3] The global burden of chronic suppurative otitis media is estimated around 65-330 million of which 60% suffer from significant hearing impairment. It accounts for 28,000 deaths and a disease burden of more than 2 million DALYs. Incidence of CSOM is higher in developing countries because of poor socio-economic standards, poor nutrition and lack of health education. It affects both sexes and all age groups. In India, the overall prevalence rate is 46 and 16 persons per thousand in rural and urban population respectively. It is also the single most important cause of hearing impairment in rural population. Surgery plays an important role in its management and the outcome measures are closure of tympanic membrane perforation in myringoplasty, eradication of disease and achievement of a dry and safe ear in mastoidectomy and in some cases, improvement of hearing where ossicular reconstruction or ossiculoplasty is also carried out. A mastoidectomy done along with tympanoplasty may ensure clearance of disease, saves time, money, unnecessary hospital stay, and repeated hospital visits for the patient. Cortical Mastoidectomy combined with Myringoplasty enhances the efficacy of graft uptake and the surgical success rate by complete clearance of the disease from Mastoid antrum and restoration of the pressure buffering capacity of Middle ear. Patients from low socioeconomic strata who are hesitant for frequent follow up should be given complete disease clearance by doing Mastoidectomy with Myringoplasty as a single procedure. Combining Mastoidectomy with Myringoplasty does not produce any statistical significance in the postoperative hearing results. Mastoidectomy should be favoured along with Myringoplasty when there is coexistence of confounding factors such as mucosal changes, bilaterality, sclerosed and contracted mastoid.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | cortical mastoidectomy ; myringoplasty ; chronic suppurative otitis media. |
| Subjects: | MEDICAL > Otolaryngology |
| Depositing User: | Devi S |
| Date Deposited: | 10 Jul 2017 07:15 |
| Last Modified: | 31 Mar 2018 07:54 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/1284 |
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