Duration Of Ear Discharge Research Articles

Successful paediatric tympanoplasy – An overview

Paediatric tympanoplasty is regarded by many as being less successful than in adults due to higher incidence of otitis media. In our study, we are trying to determine the pre-operative conditions that influence the success of paediatric tympanoplasty and construct a prognostic index for the same.To determine which pre-operative conditions or surgical technique may influence the success of pediatric tympanoplasty and to construct a prognostic index for the same.40 children between 8-15 years were included in this prospective study between June 2018- August 2019 in Department of ENT, in our institution. Pure Tone Audiograms were recorded pre and post operatively.The positive outcomes measured were integrity of tympanic membrane, minimum of 10decibel gain in auditory threshold and air filled space in middle ear. Higher success rate was observed in cases with elder age group (12-15 years), shorter duration of ear discharge, longer period of dry ear and small size of perforation.Tympanoplasty in children is a current and controversial theme. We have made a novice attempt to define factors that predict success or failure in paediatric tympanoplasty.

EVALUATION OF SENSORINEURALHEARING LOSS IN TUBOTYMPANIC TYPE OF CHRONIC SUPPURATIVE OTITIS MEDIA

Background: 
 
 To know the prevalence of sensorineural hearing loss among chronic suppurative otitis media patients
 To study the correlation between duration and clinical findings of CSOM with the degree of hearing loss.
 
 Materials and Methods 
 Hospital based cross sectional study of patients aged between 10 to 45years with unilateral chronic suppurative otitis media attending Tirumala Super speciality Hospital, Kadapa from December 2015 to November 2017 with sample size of 100 cases were taken.
 Results: Out of the 100 cases, 10 patients were having sensorineural hearing loss. Thus the percentage is 10%. Out of the 10 cases of sensorineural hearing loss, no cases with sensorineural hearing loss between 10-15yr and 16-20yr age group. 2 were between in the age group of 26-30yr, 31-35yr and 36-40yr age group and 4 patients were in the age group of 41-45yr. Out of 100 patients 52 were males and 48 were females. Out of 10 patients with sensorineural hearing loss 6 were males and 4 were females. The duration of ear discharge ranged from 3 months to more than 15 years. Among the 100 patients studied 64 had ear discharge from 3months to 5yr. 16 had ear discharge from 6-10yr, 11 had ear discharge from 11-15yr and 9 had ear discharge of more than 15years.
 Conclusion: Our study shows presence of significant (10%) sensorineural hearing loss in patients with chronic suppurative otitis media.
 Duration of ear discharge correlates well with sensorineural hearing loss.
 No significant correlation between sex and sensorineural hearing loss.
 Keywords: Chronic suppurative otitis media, tubotympanic disease, sensorineural hearing loss.

Study the Effect of Tubotympanic Disease on Bone Conduction Threshold.

Tubo-tympanic disease of middle ear cleft can temporarily detoriate the bone conduction threshold specially in higher frequency in long standing cases. It mainly affects the inertial ossicular component of the bone conduction mechanism. (1) Study the effect of tubotympanic disease on bone conduction threshold (SN loss). (2) Study the duration of the disease on bone conduction threshold. 84 cases of tubotympanic disease were taken for the study. There pre-operative PTA was done and effect of the disease on the bone conduction threshold was noted. Results were analyzed by using analysis of variance. The significance level α was taken 0.05 as at marginally significant, 0.01 significant and 0.001 as highly significant. The bone conduction at all frequencies increased significantly P < 0.05 with duration of ear discharge. The differences in the bone conduction at all frequencies amongst normal ears were significantly lower as compared to the diseased ear. Duration of ear discharge and type of hearing loss reveals that in patients with ear discharge less than 11years there were 24 (77.41%) subjects with conductive hearing loss, 1 (3.22%) subject with mixed hearing loss. As the duration increased 11-20years, the cases of conductive hearing loss decreased 13 (56.52%) and cases of mixed hearing loss increased to 3 (13.04%). In patients with ear discharge of > 21years conductive subjects were 19 (63.33%) and subjects with mixed hearing loss increased to 5 (33.33%) cases. The average hearing loss and the average bone conduction threshold increases as the duration of disease increases. In patients of safe CSOM who have poor BCT, it is the higher frequencies which are more affected.

A prospective study of outcome of boomerang-shaped chondroperichondrial graft in Type i tympanoplasty

Context: Cartilage has proven to be an excellent graft material inside the middle ear. The use of cartilage for tympanic membrane grafting may provide additional benefits in some difficult situations. Aims: The study was planned to evaluate the graft uptake and hearing after placement of “boomerang-shaped chondroperichondrial graft” in Type I tympanoplasty. Settings and Design: The prospective study was conducted on 40 patients having chronic suppurative otitis media with no active disease at least for last 6 weeks in a tertiary care center of North India. Patients having cholesteatoma and ossicular erosion/or necrosis were excluded from the study.Subjects and Methods: Those patients underwent tympanoplasty Type I by postaural approach and underlay grafting using “boomerang-shaped chondroperichondrial graft” from tragal cartilage and were followed up for 3 months. Hearing evaluation was performed preoperatively and postoperatively after 3 months. Statistical Analysis Used: The mean, range, and standard deviation of air conduction and air-bone gap were calculated and compared with preoperative findings. Results: The mean age of study group was 26.23 ± 12.46 years. Ear discharge (100%) and hearing impairment (87.5%) were the chief presenting complaints. The mean duration of ear discharge was 6.67 ± 6.75 years. Type I tympanoplasty was performed in all cases using “boomerang-shaped chondroperichondrial graft” harvested from tragal cartilage. Graft was taken up at the 3rd month in all patients. The preoperative mean air conduction was 43.21 ± 7.17 dB, which at the 3rd month improved to 36.49 ± 6.60 (P = 0.00004). Preoperative mean air-bone gap was 25.45 ± 8.44 dB which was improved to 19.31 ± 8.18 dB postoperatively at the 3rd month (P = 0.0014). Conclusions: Boomerang-shaped chondroperichondrial graft has excellent “take rate” in Type I tympanoplasty.

A study of occurrence of postoperative sensorineural hearing loss after middle ear surgeries

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Chronic otitis media is the most common middle ear disease that is encountered in our hospital. There are various surgical procedures that are performed in cases of COM and other similar conditions of the middle ear. Any type of otosurgical procedure involves the risk of inner ear damage. As middle ear surgery is also performed for functional reasons this risk should be taken into consideration. There have been some studies mentioning many insults to the cochlea during middle ear surgeries. Some studies claim that sensorineural hearing loss post-surgery is not significant at all. In view of these contradictory studies, further study is essential on this subject&lt;span lang="EN-IN"&gt;. &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; All patients undergoing middle ear surgeries are subjected to pure tone audiometry pre-operatively and tenth day, one month and three months postoperatively. Hearing assessment done with pure tone audiometer. The hearing threshold for pure tone audiometer was determined in a sound treated room at frequencies ranging from 125-8000 Hz for air conduction and 250-4000 Hz for bone conduction&lt;span lang="EN-IN"&gt;. &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Sensorineural hearing loss was not found in any of the patients postoperatively on 10th day 1st month and 3rd month&lt;span lang="EN-IN"&gt;. &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; There was no significant variation between preoperative and postoperative bone conduction levels. Therefore middle ear surgeries have not resulted in any SNHL. Duration of ear discharge, duration of surgery, type of surgery had no bearing on postoperative sensory neural hearing levels&lt;span lang="EN-IN"&gt;.&lt;/span&gt;&lt;/p&gt;

Interventions for children with ear discharge occurring at least two weeks following grommet (ventilation tube) insertion.

Interventions for children with ear discharge occurring at least two weeks following grommet (ventilation tube) insertion.

A Case-Control Study of Nutritional Factors Associated with Chronic Suppurative Otitis Media in Yemeni Children

Background: Undernutrition and chronic suppurative otitis media (CSOM) in children are common in low resource settings but there are few studies of their interactions. Aim: To evaluate nutritional factors associated with CSOM in Yemeni children. Methods: A case-control study of 75 children with CSOM and 74 healthy controls. Assessment included dietary history, anthropometry, haemoglobin, and serum analytes zinc, copper, selenium, iron, calcium, phosphate and total 25-hydroxy vitamin D [25(OH)D]. Results: Cases had lower mean z scores for weight-for-age, weight-for-height, body mass index (BMI) and mid-upper arm circumference (MUAC) (all P< 0.05), and lower mean concentrations of serum zinc (P=0.032), selenium (P< 0.001) and calcium adjusted for albumin (P=0.026). Age-adjusted haemoglobin and iron biomarkers did not differ between cases and controls. There was high prevalence of low serum zinc concentration (≥90%), and vitamin D deficiency in both cases (80%) and controls (96%). Duration of ear discharge was negatively correlated with total 25(OH)D, calcium adjusted for albumin, phosphate, transferrin receptor/log ferritin ratio, and copper (all P< 0.05); and positively correlated with child age and MUAC (both P< 0.001). Conclusions: Children with CSOM were more undernourished than controls with lower mean serum zinc, selenium and calcium concentrations. Vitamin D deficient and iron replete children had longer duration of infection although this association was lost with age adjustment. Trials evaluating specific micronutrients are required in order to investigate specific nutrient-infection interactions in CSOM.

A case–control study of nutritional factors associated with chronic suppurative otitis media in Yemeni children

Undernutrition and chronic suppurative otitis media (CSOM) in children are common in low resource settings, but there are few studies of their interactions. The aim is to evaluate nutritional factors associated with CSOM in Yemeni children. A case-control study of 75 children with CSOM and 74 healthy controls. Assessment included dietary history, anthropometry, haemoglobin (Hb) and serum analytes zinc (Zn), copper (Cu), selenium (Se), iron, calcium, phosphate (PO(4)) and total 25-hydroxy vitamin D (25(OH)D). Cases had lower mean Z-scores for weight-for-age, weight-for-height, body mass index and mid-upper arm circumference (MUAC) (all P<0.05), and lower mean concentrations of serum Zn (P=0.032), Se (P<0.001) and calcium adjusted for albumin (P=0.026). Age-adjusted Hb and iron biomarkers did not differ between cases and controls. There was high prevalence of low serum Zn concentration (≥ 90%) and vitamin D deficiency in both cases (80%) and controls (96%). Duration of ear discharge was negatively correlated with total 25(OH)D (P=0.028), calcium adjusted for albumin (P<0.001), PO(4) (P=0.002), transferrin receptor/log ferritin ratio (P<0.001) and Cu (P<0.001), and positively correlated with child age and MUAC (both P<0.001). Children with CSOM were more undernourished than controls with lower mean serum Zn, Se and calcium concentrations. Vitamin D-deficient and iron-replete children had longer duration of infection, although this association was lost with age adjustment. Trials evaluating specific micronutrients are required in order to investigate specific nutrient-infection interactions in CSOM.

A case–control study of nutritional factors associated with chronic suppurative otitis media in yemeni children

BackgroundUndernutrition and chronic suppurative otitis media (CSOM) in children are common in low resource settings but there are few studies of their interactions.ObjectiveThe purpose of this study was to determine...

Complications in primary and secondary acquired cholesteatoma: a prospective comparative study of 62 ears

Objectives This study aimed to compare the clinicopathologic behavior of complications in primary and secondary acquired cholesteatoma and figure out the differences between them. Design This was a prospective cross-sectional study. Methods This was a study conducted in a tertiary referral medical college hospital comprising of 62 ears, of which 32 were in the primary acquired cholesteatoma group (PACG) and 30 were in the secondary acquired cholesteatoma group (SACG). We compared the 2 groups with respect to 7 prognostic variables, as follows: age distribution, sex, duration of ear discharge, pathology in the ear, predisposing disease focus in nose and throat, pattern of complications, and microbiology of ear. Observation and results The presence of cholesteatoma increased the risk for complications by more than 2 times in PACG, but the presence of granulation tissue did not show the same risk. More than half of the ears with complication contained some or the other predisposing disease focus in the nose or throat. The PACG was 3 times more prone to complications than the SACG in the presence of these foci. They showed a similar pattern of complications. Brain abscess and mastoid infections were the commonest complications. Conclusions The PACG was more prone to complications than the SACG in the presence of cholesteatoma and focus in the nose and throat. Irrespective of the different pathologic origin of the 2 types, the patterns of complications remained the same with no major differences, indicating a common final pathway in the natural course of the disease.

Clinico-epidemiological study of complicated and uncomplicated chronic suppurative otitis media

This study aimed to compare the clinical and epidemiological profiles of cases of complicated and uncomplicated chronic suppurative otitis media, based on their prognostic factors. This was a prospective, cross-sectional study conducted in a tertiary care medical college hospital over a period of two and a half years. The study group comprised 187 ears, out of which 62 had complications while 125 did not. The two groups were compared with respect to nine prognostic variables: age distribution, sex, patient's domicile, literacy status, duration of ear discharge at presentation, ear pathology, predisposing disease focus in the nose or throat, ear swab microbiology, and hearing loss. Patients in the complicated chronic suppurative otitis media group had a higher male predominance and were younger. Rural and illiterate patients had a higher risk of developing complications. Cholesteatoma and granulation tissue were potential risk factors in the complicated chronic suppurative otitis media group. Ears with complications were more prone to develop sensorineural hearing loss. Age, sex, duration of ear discharge, predisposing disease focus in nose or throat, and ear swab microbiology were all less useful prognostic indicators of complications. Early detection and timely treatment of chronic suppurative otitis media in rural and illiterate patients may prevent life-threatening complications and reduce their incidence. Ears that harbour relatively large quantities of both cholesteatoma and granulation tissue together require more urgent surgical intervention and more extensive disease clearance in order to prevent complications.

Prognostic factors in complicated and uncomplicated chronic otitis media

Purpose: The aim of the present study was to determine the factors that make a patient of chronic suppurative otitis media more susceptible to the development of a complication. Materials and Methods: A prospective study of 125 patients of both complicated and uncomplicated cases of chronic suppurative otitis media who underwent mastoid surgery was undertaken to study the percentage proportion of various complications and to correlate various variables, such as age, sex, duration of ear discharge, otoscopy, operative findings, state of pneumatization, and microbiology of the ear. Results: It was found that patients with complicated ear disease had ear discharge for a shorter duration compared with those without complications. The difference was statistically significant ( P < .05). There was no significant difference in the otoscopic findings in both the groups. At surgery, presence of granulation tissue was significantly seen in the group with complications ( P < .05). Radiologically, degree of mastoid pneumatization had no significant difference in the two groups, except the presence of lytic lesion in patients more than 15 years of age in the group with complications. Bacteriological examination showed significant isolation of anaerobes in patients with complications ( P < .01). Conclusion: A history of ear discharge for a short duration in a younger patient less than 15 years of age, the presence of anaerobes in the ear discharge, and granulation tissue at surgery increase the probability of development of a complication in patients with chronic suppurative otitis media.

Observation of hearing loss in patients with chronic suppurative otitis media tubotympanic type

It is acknowledged that size and site of tympanic membrane perforation is proportional to degree of hearing loss but there are many studies which suggests otherwise. Persistent ear discharge is also supposed to deteriorate hearing level with passage of time. This study is carried out to find out the relation between size and site of tympanic membrane perforation and duration of ear discharge on hearing loss. The objective of this study is to study the effect of size and site of tympanic membrane perforation and duration of ear discharge on hearing loss. This is a cross-sectional prospective study conducted at Kathmandu Medical College, department of ear nose and throat from January till July 2009. One hundred patients aged between 8 to 60 years with pars-tensa perforations were included in the study. Detail clinical examination and history was carried out followed by hearing evaluation by audiometry was done in all cases. All the data is collected, statistical analysis is done using SPSS program and documented for study. One hundred patients with 119 perforated tympanic membrane, age ranged between 8 to 60 years, 44 males and 56 females were studied. Bilateral tympanic membrane perforation were seen in 19 patients, right sided perforation in 39 and left sided in 42 patients respectively. Large central perforation involving all four quadrants was the most common otologic findings seen in 72 ears (60.50%) whereas perforation in posterosuperior quadrant was the least common finding seen in 3 patients (2.52%). Significant relation is observed between site of perforation and degree of hearing loss; posterior placed perforations seem to have larger hearing loss. Ninety-five perforations (79.83%) showed more loss in low frequencies with larger air bone gap at low frequencies. The longer the duration of ear discharge, the more the hearing loss. The larger the perforation, the greater the decibel loss in sound perception. The location of perforation on the tympanic membrane and the duration of ear discharge have significant effect on the magnitude of hearing loss.