Devashri Uday Patil ¹, Kiran S. Burse ², Shreeya Vinay Kulkarni ¹, Vandana Sancheti ³, Chaitanya Bharadwaj ²

Affiliations
1 MS ENT, Dr. Vasantrao Pawar Medical College Hospital, Nashik, IN
2 ENT Department, Dr. Vasantrao Pawar Medical College Hospital, Nashik, IN
3 ENT Department, DLO, Dr. Vasantrao Pawar Medical College Hospital, Nashik, IN

Abstract

Chronic suppurative otitis media is one of the common otological conditions in India for which patients seek advice from an otorhinolaryngologist. Chronic suppurative otitis media is recurrent and progressive disease which is characterized with tympanic membrane perforation and suppurative discharge. Pure tone audiometry is the most common test used to evaluate auditory sensitivity. Since hearing loss is a common complication of chronic suppurative otitis media, we designed this study to evaluate preoperative pure tone audiometry findings in patients with chronic suppurative otitis media and its correlation with the intra-operative findings. Aims and Objectives: 1] To assess the intra-operative findings in patients with chronic suppurative otitis media. 2] To evaluate the correlation between the preoperative pure tone audiometry findings and intra-operative findings in patients with chronic suppurative otitis media. 3] To assess the type of hearing loss and degree of hearing loss in patients with chronic suppurative otitis media. Materials and Methods: This is an Observational study carried over a period of 3 years from August 2011 to August 2013. Total number of patients included in this study was 100. Result: Out of 100 patients studied 69 % of patients had Tubo-Tympanic type of CSOM, 31 % of patients had Attico-antral type of CSOM. In patients of Safe CSOM; Central perforation was seen in maximum cases 46.4 %, anterior central perforations was seen in 8.7 % cases, posterior central perforations seen in 20.2 % cases, and subtotal perforations seen in 24.63 % cases. In patients of Unsafe CSOM posterosuperior cholesteatoma was seen in maximum cases 67.74 %, and attic cholesteatoma was seen in 32.2 % cases. In safe CSOM patients all ossicles were intact and mobile whereas in unsafe CSOM patients only 4 patients had intact ossicular chain, while maximum patients had ossicular defect. Conclusion: Hearing loss depends on size of perforation. Hearing loss increases as the size of perforation increases. Average air conduction threshold and air bone gap did not differ significantly between various groups of ossicular defect. This shows us that neither air conduction nor air bone gap are reliable parameters on basis of which we can predict ossicular status preoperatively.

Keywords

Chronic Suppurative Otitis Media, Hearing Loss, Puretone Audiometry, Air Bone Gap.

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Sharyu Siddharth Shelke ¹, Shreeya Vinay Kulkarni ²

Affiliations
1 PG Resident, Department of ENT, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422002, Maharashtra, IN
2 Professor, Department of ENT, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422002, Maharashtra, IN

Abstract

Introduction: Chronic nasal obstruction is one of the most common chronic diseases and affects nearly 50 million individuals every year the world over. The diagnosis of diseases associated with chronic nasal obstruction relies heavily on the clinical judgment. However the degree of accuracy in diagnosis of many reported cases with chronic nasal obstruction has exponentially increased owing to modern diagnostic methods like computed tomography of paranasal sinuses and diagnostic nasal endoscopy. The aim of the study is to implement the consistency among the findings of CT, X ray soft tissue and endoscopic findings of the PNS. This will help in a better understanding of the disease, its diagnosis and management. Methodology: This was a prospective observational study. The study was conducted in all the patients coming to the department of ENT in a tertiary health care centre. Patients of any age group with a history of nasal obstruction > 3 months not resolved in spite of medications were included in the study. An informed consent was obtained from the participants. Diagnostic nasal endoscopy and CT Scan PNS and or x-ray nasopharynx was done in 35 patients, suffering from chronic nasal obstruction. Results: A highly significant positive correlation was found between nasal endoscopic and radiological findings. Conclusion: A detail assessment of radiological and endoscopic findings is necessary for tailoring surgical plan .No single procedure can be sufficient in accurately diagnosing chronic nasal obstruction and both the preoperative CT and endoscopic examination are complementary to each other.

Keywords

Chronic Nasal Obstruction,Computed Tomography, Diagnostic Nasal Endoscopy

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Rohan Vijay Gupta ¹, Shreeya Vinay Kulkarni ², Kiran Burse ³, Chaitanya Bharadwaj ⁴, Vandana Sancheti ⁵, Rushika Patel ⁶

Affiliations
1 Former PG Resident, Department of ENT, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, Maharashtra, IN
2 Professor, Department of ENT, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, Maharashtra, IN
3 Professor and Head, Department of ENT, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, Maharashtra, IN
4 Associate Professor, Department of ENT, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, Maharashtra, IN
5 Senior Resident, Department of ENT, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, Maharashtra, IN
6 Assistant Professor, Department of ENT, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, Maharashtra, IN

Abstract

Background: Chronic suppurative otitis media is a common otological condition in India causing hearing loss for which patients seek advice from an otolaryngologist. The perforation seen in chronic suppurative otitis media may be the only sequel remaining when the pathological process in middle ear cleft has healed. Tympanoplasty, the procedure for repairing the perforations of the pars tensa, can be done using a variety of graft materials. In this study two different types of graft materials, fascia lata and temporalis fascia, which can be used in tympanoplasty will be studied. The study will help to know which is better in terms of graft uptake as well as improvement in hearing. This will help in a better understanding of which grafts can be used in tympanoplasty in the future. Aims and Objectives: To compare hearing gain and graft uptake rate between temporalis fascia and fascia lata in tympanoplasty and to study the postoperative morbidity/complications associated with the 2 modalities. Materials and Methodology: The study was conducted on 42 patients divided in 2 groups of 21 each. The 1st group underwent tympanoplasty type 1 by endomeatal approach using fascia lata graft and the 2nd group by a post aural approach using temporalis fascia graft. Regular follow ups and otoscopic examination was done on the patients to check the graft uptake. Pure tone audiometry was done after a minimum period of 2 months post-surgery and was compared with the preoperative audiometry to assess the hearing improvement in hearing. Results and Conclusions: This study compared both temporalis fascia and fascia lata as graft materials used in tympanoplasty. Graft uptake results and gain in hearing were better with temporalis fascia as compared to fascia lata. Temporalis fascia was also associated with lesser post-operative complications. So this study finds that tympanoplasty done by postaural technique using temporalis fascia is better in terms of graft uptake, hearing improvement and postoperative complications when compared to tympanoplasty done by fascia lata.

Keywords

Endomeatal, Fascia Lata, Postaural, Temporalis Fascia, Tympanoplasty

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