DYNAMIC STUDY OF HEARING IN CHILDREN AFTRE SANTIZING SERGON ON THE MIDDEL EAR

Dynamic assessment of hearing in pediatric patients having chronic suppurative otitis media with cholesteotoma was conducted. The patients included into the study were assessed after surgeries performed by canal wall up or canal wall down technique without any timpanoplasty. Functional outcomes and frequency of recurrence were estimated. We carried out a retrospective and prospective analysis of hearing ability in 35 children who had undergone surgery in ENT clinic of Saint-Petersburg State Pediatric Medical University (37 ears were operated on as two patients had bilateral lesions). Hearing ability was investigated by tone threshold audiometry. All the patients studied were followed up for not less then 1 year. Hearing ability was evaluated before the surgery,6 months and 12 months after the surgery. Hearing findings before the surgery in children operated on by canal wall up technique showed a more significant hearing loss than the ones done by the other technique. All ears demonstrated no significant hearing loss progress in both groups. However, the children after canal wall up surgery showed more frequent cholesteatoma recurrences which resulted in the need of other surgeries. Carrying out canal wall up surgery on the middle ear in children makes it possible to maintain hearing at a socially adequate level.

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Chronic Suppurative Otitis Media Atticoantral- Type Undergone Canal Wall Down Mastoidectomy in a Peripheral Government Hospital of Nepal

Journal of Nepal Medical Association ◽

10.31729/jnma.2433 ◽

2013 ◽

Vol 52 (192) ◽

Author(s):

Dhundi Raj Paudel

Keyword(s):

Otitis Media ◽

Chronic Suppurative Otitis Media ◽

Canal Wall ◽

Suppurative Otitis Media ◽

Hearing Ability ◽

Peripheral Hospital ◽

Operative Evaluation ◽

Canal Wall Down ◽

Canal Wall Down Mastoidectomy ◽

Operative Assessment

Introduction: Chronic suppurative otitis media is a severe type of chronic ear infection which is quite common in all geographical situations of Nepal. The mainstay of treatment of this disease is surgery, preferably of canal down method. The objective of the study was to identify the common presentation(s) and the clinical and operative finding(s) in patients with chronic suppurative otitis media attico-antral type and evaluation of efficacy of canal-wall down mastoidectomy in the achievement of dry ear and change in hearing in a setting of a peripheral hospital of Nepal in terms of subjectivity. Per-operative evaluation of mastoid cavities in terms of types of pathologies and post- operative assessment of ears in terms of achieving a dryness and change in hearing ability was carried out in the ENT Department, Bharatpur Hospital , Chitwan, Nepal. Study was done from January 2005 to December 2010. Methods: Seventy three patients with chronic suppurative otitis media atticoantral- type were evaluated preoperatively in terms of gross pathologies. Postoperatively, patients were subjectively evaluated twice in six months in reference to persistent ear discharge and change in hearing ability. Results: By six months of surgery, 75% of the patients had no discharge. Fifty two patients did not experience any change in hearing ability. Only 16% experienced betterment in hearing while 19% had diminution in hearing. Conclusions: Canal wall down mastoidectomies are very effective in controlling otorrhoea and complications related to chronic suppurative otitis media attico-antral type. Keywords: Chronic suppurative otitis media attico-antral (CSOM-AA) type; CWD masoidectomy; CWU mastoidectomy; ear cavity.

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A comparative study of hearing outcomes in canal wall up versus canal wall down mastoidectomy in our experience

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20190491 ◽

2019 ◽

Vol 5 (2) ◽

pp. 472

Author(s):

Poornima S. Bhat ◽

G. Gandhi ◽

K. Pradheep

Keyword(s):

Hearing Loss ◽

Conductive Hearing Loss ◽

Pure Tone Audiometry ◽

Canal Wall ◽

Hearing Gain ◽

Hearing Outcome ◽

Canal Wall Down ◽

Canal Wall Down Mastoidectomy ◽

Conductive Hearing ◽

Canal Wall Up

Background: COM causes considerable morbidity with ear discharge, conductive hearing loss and complications. Ossicular reconstruction is a surgical procedure which intends to improve the quality of hearing and life in such patients. Comparison of the outcomes will help to determine the merits or demerits of a particular procedure.Methods: The study was conducted in the Department of ENT, VIMS, Bellary during the period from December 2010 to May 2012. All the patients with CSOM with ossicular erosion suggested by conductive hearing loss more than 40dB were included in the study. A detailed history taking, thorough clinical examination was done for these patients. Before and after the procedure pure tone audiometry was done to assess the hearing outcome. Post operatively PTA was done in 6th week, 3rd month, 6th month follow up. Hearing improvement was analysed according to the type of procedure. The data collected was tabulated and subjected to statistical analysis. Results: This study compared the outcomes of hearing gain in canal wall up versus canal wall down mastoidectomy surgeries. Hearing gain was better in canal wall up mastoidectomy (18.36 dB) than canal wall down mastoidectomy surgeries.Conclusions: Hearing outcome was better in intact canal wall mastoidectomy than canal wall down mastoidectomy in our study.

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Surgical management of only hearing ears with positive indications

The Journal of Laryngology & Otology ◽

10.1017/s0022215106002556 ◽

2006 ◽

Vol 120 (11) ◽

pp. 972-975 ◽

Cited By ~ 3

Author(s):

M Sakagsami ◽

T Muto ◽

O Adachi ◽

Y Mishiro ◽

K Fukazawa

Keyword(s):

Hearing Loss ◽

Otitis Media ◽

Hearing Aid ◽

Chronic Otitis Media ◽

Canal Wall ◽

Surgical Indications ◽

The Past ◽

Canal Wall Down ◽

Canal Wall Up

Positive surgical indications for an only hearing ear were evaluated in order to improve patients' quality of life. Fifteen cases of surgery involving an only hearing ear over the past eight years were retrospectively reviewed. Of eight perforated chronic otitis media cases, seven underwent type one tympanoplasty and one underwent simple underlay myringoplasty regardless of otorrhoea at the time of surgery. Of six cholesteatoma cases, two received the canal wall up method and four received the canal wall down method. Ossiculoplasty was carefully performed in six cases. Hearing was improved in seven cases, whereas it remained unchanged in seven cases and deteriorated in one case. Of nine patients, two did not need a hearing aid after surgery. Five patients with severe combined hearing loss (>90 dB) were able to communicate with a hearing aid, alleviating their anxiety regarding hearing loss. Only hearing ears with chronic otitis media and cholesteatoma can be successfully treated by tympanoplasty with or without ossiculoplasty.

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Hearing gain after tympanoplasty: a prospective study

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20202206 ◽

2020 ◽

Vol 6 (6) ◽

pp. 1096

Author(s):

Manzoor Ahmad Latoo ◽

Romesh Bhat ◽

Aleena Shafi Jallu

Keyword(s):

Hearing Loss ◽

Pure Tone ◽

Pure Tone Audiometry ◽

Type I ◽

Type Ii ◽

Canal Wall ◽

Type Iv ◽

Canal Wall Down ◽

Type I Tympanoplasty ◽

Canal Wall Up

Background: The aim of the present study was to determine hearing improvement in different types of tympanoplasties by comparing mean preoperative air bone (AB) gap with mean postoperative AB gap. The study focused on reconstruction of tympanic membrane and ossicular apparatus by tympanoplasty alone or tympanoplasty with mastoid surgeries (canal wall up or canal wall down).Methods: 60 patients of either sex having chronic otitis media with conductive hearing loss of >20 dB were included in the study. Each patient had to undergo preoperative and postoperative pure tone audiometry to calculate average AB gap. Patients underwent tympanoplasty, with or without mastoid exploration depending on the disease status. Pure tone audiometry (PTA) was done at 3 months and 6 months and compared with pre-operative PTA. Results: Preoperatively PTA showed 29 (48.33%) patients had mild degree of hearing loss, followed by moderate degree of hearing loss in 18 (30.0%) patients. 10 (16.67%) patients had minimal hearing loss and moderately severe hearing loss was seen in 3 (5%) patients. Tympanoplasty alone was done in 52 patients (86.67%). Tympanoplasty with canal wall up mastoidectomy was done in 6 (10%) and tympanoplasty with canal wall down mastoidectomy was done in 2 (3.33%) patients. Type I tympanoplasty was performed in 37 (61.6%) patients, type-III tympanoplasty was the type of surgery in 15 (25.0%) patients. Type II and type IV tympanoplasties were performed in 4 (6.7%) patients each separately.Conclusions: Hearing gain is better in type I tympanoplasty than in tympanoplasty type II, type III and type IV with or without mastoid surgeries.

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A study on the effect of grommet as partial ossicular replacement prosthesis in type III tympanoplasty in patients with chronic suppurative otitis media

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20200048 ◽

2020 ◽

Vol 6 (2) ◽

pp. 263

Author(s):

M. D. Prakash ◽

Lyra Joy ◽

Priya Jose

Keyword(s):

Otitis Media ◽

Ossicular Chain ◽

Canal Wall ◽

Hearing Improvement ◽

Suppurative Otitis Media ◽

Type Iii ◽

Ossicular Replacement ◽

Canal Wall Down ◽

Replacement Prosthesis ◽

Canal Wall Up

Background: Chronic otitis media (COM) with or without cholesteatoma causes ossicular erosion/ destruction which leads to conductive hearing loss. Ossiculoplasty is to reconstruct the hearing mechanism in ear after eliminating the disease from the middle ear. In our study we used ventilation tubes or grommet as partial ossicular replacement prosthesis (PORP) for the reconstruction of the ossicular chain especially when the stapes is mobile. The objective of the study is to assess the degree of hearing improvement by using grommet as PORP in type III tympanoplasty.Methods: It was an observational study from July 2018 to July 2019. 20 patients with COM undergoing canal wall up or canal wall down mastoidectomy with intraoperative ossicular chain erosion with intact stapes suprastructure were included in this study. Post-operative hearing gain and graft uptake was assessed at 3rd month. Results: Among these 20 patients 15 underwent canal wall up mastoidectomy with type III tympanoplasty and 5 underwent canal wall down procedure with type III tympanoplasty. Incus was eroded in 17 cases, malleus in 2 cases and malleus with incus eroded in 1 case. The pre op average airborne gap was 38 dB and mean improvement of 12 dB was observed at third month.Conclusions: Grommet tube used as PORP is an effective alternative in the reconstruction of ossicular chain with good hearing improvement.

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Correlation between functional outcome and the SAMEO-ATO framework

European Archives of Oto-Rhino-Laryngology ◽

10.1007/s00405-021-07000-3 ◽

2021 ◽

Author(s):

Vito Pontillo ◽

Marialessia Damiani ◽

Giusi Graziano ◽

Nicola Quaranta

Keyword(s):

Functional Outcome ◽

Middle Ear ◽

Petrous Bone ◽

Canal Wall ◽

Hearing Results ◽

Tertiary Referral Center ◽

Ossicular Reconstruction ◽

Canal Wall Down ◽

Mastoid Surgery ◽

Canal Wall Up

Abstract Purpose To evaluate the recently proposed SAMEO-ATO framework for middle ear and mastoid surgery, by correlating it with the functional outcome in a large cohort of patients operated for middle ear and mastoid cholesteatoma in a tertiary referral center. Methods We retrospectively included all surgeries for middle ear and mastoid cholesteatoma undergone in our Department between January 2009 and December 2014, by excluding revision surgeries, congenital and petrous bone cholesteatoma. All surgeries were classified according to the SAMEO-ATO framework. The post-operative air bone gap (ABG) was calculated and chosen as benchmark parameter for the correlation analysis. Results 282 consecutive surgeries for middle ear and mastoid cholesteatoma were released in the study period on a total of 273 patients, with a mean age of 41.2 years. All patients were followed for an average period of 55.3 months. 54% of patients underwent M2c mastoidectomy (Canal Wall Down, CWD), while the remaining underwent Canal Wall Up (CWU) procedures, being M1b2a mastoidectomy the most common one (33%). Mean pre-operative and post-operative ABGs were 29.2 and 23.5 dB, with a significant improvement (p < 0.0001). ‘Mastoidectomy’ and ‘Ossicular reconstruction’ parameters of SAMEO-ATO showed significant association with postoperative ABG, with smaller residual gaps for the classes Mx and On, and worse hearing results for M3a and Ox. Conclusion Our results show the utility of SAMEO-ATO framework, and in particular of ‘M’ (Mastoidectomy) and ‘O’ (Ossicular reconstruction) parameters, in predicting the hearing outcome.

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Four layers reconstruction of the posterior ear canal wall in one stage surgery

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20211933 ◽

2021 ◽

Author(s):

Khaled M. Mokbel Khalefa

Keyword(s):

Otitis Media ◽

Recurrent Infection ◽

Posterior Wall ◽

Chronic Suppurative Otitis Media ◽

Canal Wall ◽

Suppurative Otitis Media ◽

Posterior Canal ◽

One Stage ◽

Canal Wall Down ◽

Canal Wall Down Mastoidectomy

Background: Canal wall down mastoidectomy are still practiced in cases of chronic suppurative otitis media with cholesteatoma to ensure complete disease removal. The resulting cavity is prone to recurrent infection, chronic discharge and frequent care. Reconstruction of the posterior canal wall should be planned by the surgeon. Various techniques for external auditory canal (EAC) reconstruction have been recommended to eliminate open cavity problems. The surgeon should choose the type of grafts either autologous, homografts or synthetic materials. Furthermore, the surgeon should decide whether to do the reconstruction either immediate in the first stage of surgery or delayed as a second stage.Methods: In this study, the ridge was reconstructed at the same time of mastoidectomy by autologous tissues. The presenting study reconstructed the posterior canal wall in four layers; skin, perichondrial flap, cartilage and periosteal flap in that order from the meatal side to the mastoid side. The presenting study included 48 patients (32 males and 16 females) with age ranged from 18-55 and 20-50 years. All included patients were presented at the outpatient clinic with unilateral chronic suppurative otitis media with persistent discharge. They had been operated at our tertiary hospital between January. 2012 to March 2014.Results: Successful reconstruction was obtained in all cases, with no dehiscence or necrosis.Conclusions: The reconstruction of the posterior wall by the four layers technique was successful and efficient. It is recommended to do this repair concomitantly with canal wall down mastoidectomy as one stage surgery.

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Hearing Status After Ossiculoplasty in Open Cavity Mastoidectomy

Bangladesh Journal of Otorhinolaryngology ◽

10.3329/bjo.v23i2.45167 ◽

2020 ◽

Vol 23 (2) ◽

pp. 195-198

Author(s):

Md Zakaria Sarker ◽

DC Talukder ◽

Khabir Uddin Patuary ◽

Md Rafiqul Islam ◽

Saif Rahman Khan ◽

...

Keyword(s):

Hearing Loss ◽

Ossicular Chain ◽

Ear Reconstruction ◽

Canal Wall ◽

Prospective Longitudinal Study ◽

Hearing Gain ◽

Canal Wall Down ◽

Canal Wall Down Mastoidectomy ◽

Middle Ear Reconstruction ◽

Prospective Longitudinal

To evaluate the hearing outcome in canal wall down mastoidectomy with middle ear reconstruction, prospective longitudinal study was done at National Institute of ENT, Dhaka from March 2015 to September 2016. Total 22 patients were included in the study undergoing canal wall down mastoidectomy with 6 months postoperative followup. Hearing outcomes were observed and compared with the preoperative hearing tests. Among the 22 patients 9 (39.1% of subjects) patients had hearing gain, 12 (52.2%) had hearing loss and 1 (4.3%) had no change in hearing postoperatively.Although disease clearance is the main objective in canal wall down mastoidectomy, hearing gain can be achieved if combined with ossiculoplasty and tympanoplasty. The hearing gain or loss depends upon the extension of disease and status of the ossicular chain. Most patients usually experience hearing loss more than the preoperative period due to removal of ossicle or ossicles for the sake of disease clearance. Bangladesh J Otorhinolaryngol; October 2017; 23(2): 195-198

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