Janani, J (2022) Importance of Eustachian Tube Function in Deciding the Outcomes of Surgery in Chronic Suppurative Otitis Media - Mucosal Type (Inactive & Active). Masters thesis, Madras Medical College, Chennai.
|
Text
220400122janani.pdf Download (1MB) | Preview |
Abstract
INTRODUCTION: The eustachian tube is an organ consisting of lumen with its mucosa, cartilage, surrounding soft tissue, para tubal muscles and bony support. Eustachian tube systems is contiguous organs including the nose, palate, nasopharynx, ET, middle ear, and mastoid air cells. The eustachian tube's patency and appropriate functioning are essential for normal middle ear function. Any eustachian tube malfunction causes negative pressure to build up in the tympanum, resulting in retraction, effusion, and other problems. In terms of the middle ear, the Eustachian tube serves three purposes. Ventilation or pressure regulation is the physiologic function of the eustachian tube to regulate atmospheric pressure and gas pressure between the nasopharynx and middle ear. Protection is the physiologic function of the eustachian tube in which unwanted nasopharyngeal secretions and sound pressures are prevented from entering the middle ear by the unique structural and functional aspects of the tubal system. AIMS AND OBJECTIVES PRIMARY OBJECTIVE: 1. To relate the outcome of surgery for CSOM-MUCOSAL DISEASE (INACTIVE AND ACTIVE). SECONDARY OBJECTIVE: 1. To study the patency of Eustachian tube in chronic suppurative otitis media (mucosal type). 2. To study the muco-ciliary function of Eustachian tube. 3. To study if there is any relation between site of perforation and graft uptake. MATERIALS AND METHODOLOGY Study Place: Rajiv Gandhi Government General Hospital, Chennai - 600 003. Department: Upgraded Institute of Oto-rhino-laryngology. Study Design: Prospective. Period of the study: June 2020- September 2021. Ethical clearance: Obtained. INCLUSION CRITERIA: 1. Patients suffering from chronic suppurative otitis media (mucosal disease – active and inactive) > 12 years of age. 2. Male and female patients 3. Patients with both unilateral and bilateral disease. 4. Patients who are able to understand and give consent for the study. EXCLUSION CRITERIA: 1. Patients with CSOM- mucosal disease with non-intact tympanic membrane. 2. Patients with attico-antral disease. 3. Age less than 12 years. 4. Patients suffering from congenital anomaly/ cleft palate /tumor or mass in the nasopharynx. 5. Those who are not willing/ loss to follow up. INVESTIGATIONS: 1. Plain Xray both Mastoids, 2. Pure tone audiometry, 3. Impedance audiometry, 4. Oto-endoscopy, 5. Diagnostic nasal endoscopy, 6. Methylene blue Dye test. DATA COLLECTIONS : Clinical. BENEFIT TO THE COMMUNITY: 1. A properly functioning Eustachian tube is an integral part of normally functioning middle ear and existence of good muco-ciliary drainage constitutes a favorable prognostic factor for reconstructive surgery of the middle ear. 2. Preoperative and Intraoperative corrective measures can be taken in patients with partial and absent tubal function to improve the success rate. Conflict Of Interest: NIL. Financial Support: NIL. Principal Investigator: Dr.J.Janani, MS ENT, Post-Graduate. CONCLUSION: • A functioning ET is an integral part of a normal middle ear & is an essential requirement for Optimum results after surgery for CSOM. • Preoperative evaluation of Eustachian Tube Function thus becomes mandatory to decide the type of surgery for chronic suppurative otitis media patients. • Impedance audiometry (Forced inflation test/passive test) & Methylene blue dye test are important tools to assess the functions of eustachian tube and mastoid pneumatization. • We used methylene blue Dye test to assess the muco-ciliary function of eustachian tube and it was significant with post operative graft uptake (p value- 0.038). • Dye test assesses the drainage pattern of ET and establishes the anatomical presence or absence of tube patency. • Anterior perforation with normal muco-ciliary function group of patients has better graft uptake when compared to group of patients with muco-ciliary dysfunction. • Mastoid pneumatization correlates with impedance audiometry. • Regular post operative follow up measures and care has to be taken to improve the outcomes of surgery for chronic suppurative otitis media.
| Item Type: | Thesis (Masters) |
|---|---|
| Additional Information: | 221914012 |
| Uncontrolled Keywords: | Eustachian Tube Function, Deciding, Outcomes, Surgery, Chronic Suppurative Otitis Media, Mucosal Type, Inactive & Active. |
| Subjects: | MEDICAL > Otolaryngology > MEDICAL > Otolaryngology |
| Depositing User: | Subramani R |
| Date Deposited: | 22 Apr 2022 14:03 |
| Last Modified: | 17 Dec 2023 05:30 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/19369 |
Actions (login required)
 |
View Item |
