305
The Journal of Medical Research 2020; 6(6): 305-308
Research Article
JMR 2020; 6(6): 305-308
November- December
ISSN: 2395-7565
© 2020, All rights reserved
www.medicinearticle.com
Received: 24-11-2020
Accepted: 31-12-2020
*Corresponding author:
Dr. Harsh Lokhna
Junior Resident, Department of
ENT, Subharti Medical College,
Swami Vivekanand Subharti
University, Meerut- 250005,
Uttar Pradesh, india
Email: 0or1phd[at]gmail.com
To assess the hearing improvement in patients of Chronic Otitis
Media Tubotympanic type post tympanoplasty
Harsh Lokhna
1
, Sanjay Kumar
2
, Anshul Bansal
3
1
Junior Resident, Department of ENT, Subharti Medical College, Swami Vivekanand Subharti University, Meerut-
250005, Uttar Pradesh, india
2
Professor and Head, Department of ENT, Subharti Medical College, Swami Vivekanand Subharti University, Meerut-
250005, Uttar Pradesh, india
3
Professor, Department of ENT, Subharti Medical College, Swami Vivekanand Subharti University, Meerut- 250005,
Uttar Pradesh, india
Abstract
Aim: To determine hearing improvement in type- 1 tympanoplasty by comparing mean preoperative air bone gap with
mean postoperative AB gap. Material and method: Patients clinically diagnosed as 75 cases of Chronic Suppurative
Otitis Media Tubotympanic Type Disease presenting to the ENT OPD of Chhatrapati Shivaji Hospital attached to Subharti
Medical College, Meerut were taken up for study. Detailed clinical examination and history was taken. Pure tone
audiometry was conducted, hearing loss and mean AB Gap was noted pre-operatively. X-Ray mastoid B/L Schuller’s
view was done and findings were noted. Tympanoplasty type 1 with or without mastoidectomy was performed. Cortical
mastoidectomy with type 1 Tympanoplasty was performed in patients having granulations & polypoidal middle ear
mucosa along with sclerotic mastoid. All these patients were followed up post-operatively at 6 weeks. The status of
graft uptake was noted. Pure tone audiometry was performed. Hearing loss and mean AB Gap results were compared
with pre-operative findings. Results: In our study out of 75 patients, 33 (44%) patients were affected with Right ear and
42 (56%) patients were affected with Left ear. Hearing loss was the chief complaint in all 75 patients (100%) followed by
blocking sensation. Post operatively 58 (77.33%) patients had normal hearing followed by 16 (21.33) patients who had
mild hearing loss. Only 1 (1.33%) patient had moderately severe hearing loss. Pre-operatively, mean AB Gap was
46.62+/-7.89dB while post-operatively mean AB Gap was 23.43+/-5.52dB with statistically significant difference as
p<0.05. Conclusion: In our study, the post-operative Mean AB Gap was improved significantly as compared to pre-
operative mean AB Gap.
Keywords: COM, Tympanoplasty, Tympanic Membrane, AB Gap.
INTRODUCTION
Introduction: Chronic otitis media (COM), a common condition in otorhinolaryngology, it is characterized
by an inflammatory process of the mucoperiosteal lining of the middle ear space and mastoid,
characterized by chronic, intermittent, or persistent discharge through a perforated tympanic membrane
[1]
. The incidence of chronic otitis media (tubotympanic type) is high in developing countries because of
lower socioeconomic standards, poor nutrition and lack of health education
[2]
. It is a major cause of
deafness in India. There are two types of Chronic Suppurative Otitis Media i.e. Tubotympanic (safe or
mucosal) and B) Atticoantral Type (Unsafe or squamosal)
[3]
.
Chronic Tubotympanic Suppurative otitis media can be managed in two ways, conservative and surgical
management. The aim of middle ear surgery is reduction in the patient’s hearing disability, not just closure
of the air bone gap. Small perforations usually heal spontaneously but surgery is required when the edges
of the perforation are covered by stratified squamous epithelium, a perforation becomes permanent and
does not heal spontaneously
[4]
.
Tympanoplasty is the surgical operation consists of both eradication of middle ear disease and
reconstruction of hearing mechanism including tympanic membrane and ossicles
[5]
. Type-1
tympanoplasty is performed when there is tympanic membrane perforation without any ossicular damage
[6]
. Tympanoplasty with or without mastoidectomy is indicated for chronic ear disease process such as
tympanic membrane perforation resulting from previous middle ear infections, atelectasis of tympanic
membrane, retraction pocket, cholesteatoma, tympanosclerosis, and mastoid granuloma
[7]
.
This is a Prospective and observational study which is focused on Tympanoplasty and reconstruction of the
tympanic membrane. The study focused on reconstruction of tympanic membrane and inspection of
ossicular apparatus by tympanoplasty alone or tympanoplasty with mastoid surgeries. The aim of the
present study was to determine hearing improvement in type- 1 tympanoplasty by comparing mean