Relation of mastoid size in graft uptake in patients with type 1 tympanoplasty alone and type 1 tympanoplasty with cortical mastoidectomy
Journal Title: Medpulse International Journal of ENT - Year 2017, Vol 4, Issue 2
Abstract
Background: Chronic suppurative otitis media (CSOM) is an inflammation of the middle ear cleft includes middle ear cavity proper with mastoid. One of the major cause for the failure of graft uptake is infection. Simple mastoidectomy is an effective means of repneumatizing and removing disease from the mastoid. The effect of mastoidectomy on patients without evidence of active infection remains highly debated and unproven. Objectives: This study undertaken to evaluate the outcome of graft uptake in different sizes of the mastoid bone in type I tympanoplasty with cortical mastoidectomy and type I tympanoplasty alone and to compare the results between these two. Methods: The comparative study comprises of 60 patients with CSOM safe type in quiescent stage. All cases operated during a period of 2yrs. Thirty of these cases were selected for type I tympanoplasty alone (Group A) and 30 cases were selected for type I tympanoplasty with cortical mastoidectomy (Group B). Prospective cohort study is done. Patients were reviewed after 3 weeks, for inspection of operated ear. The second and third post operative reviews were done at 3rd and 6th month respectively for clinicoaudiological assessment of the operated ear with respect to graft status, ear discharge and hearing improvement. The post-operative audiograms were recorded on 2nd and 3rd visits. Results: The take up rates of graft is high in large mastoids. Better results were obtained by performing a type I tympanoplasty with cortical mastoidectomy than with a type –I tympanoplasty alone. Further more cases with a small mastoid preoperatively were benefited by a cortical mastoidectomy. a larger mastoid gives a much better take up rate, as compared to a smaller mastoid, irrespective of whether Type I tympanoplasty was done with or without cortical mastoidectomy. Conclusion: A cortical mastoidectomy is an effective means of repneumatizing the mastoid air cell system as well as eradicating the mastoid source of infection. Our study proves that a larger mastoid gives a much better take up rate, as compared to a smaller mastoid, irrespective of whether Type I tympanoplasty was done with or without cortical mastoidectomy.
Authors and Affiliations
K Mallikarjuna Swamy, Arati Ganiger
Keywords
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