Hearing Improvement Rate Research Articles

The outcomes of endoscopic myringoplasty: elevating a tympanomeatal flap or not.

The aim of this study was to compare the differences between the no tympanomeatal flap approach and the tympanomeatal flap approach in endoscopic myringoplasty. A total of 132 patients with tympanic membrane perforation were randomly divided into two groups: the no tympanomeatal flap approach group (group A, 56 ears) and the tympanomeatal flap approach group (group B, 76 ears). A comparison between the two groups was made. The average operation time of group A was 36.00 ± 5.24 minutes, which was significantly shorter than that of group B, which was 43.89 ± 4.57 minutes (p = 0.002). The blood loss of group A was 5.08 ± 1.83 ml, which was significantly less than that of group B (9.67 ± 2.29 ml; p < 0.001). There were no differences in the degree of hearing improvement, the rate of hearing improvement, the dry ear time (when the external auditory canal and the operating cavity were dry) after operation and the success rate of tympanic membrane repair when compared between the two groups. Compared with group B, group A (no tympanomeatal flap approach) can achieve the same effect but has the advantages of a shorter operation time and less blood loss during the operation.

Is It Wise to Wait for Ear to Become Dry in Indian Scenario?

Tympanoplasty is the standard and well-established procedure for closure of tympanic membrane perforations. Tympanoplasty in wet ear is still a topic of debate among ENT surgeons. This study discusses the balance between wait and watch policy and early intervention in wet ear. It also compares the rate of graft uptake and hearing improvement in Type I tympanoplasty in dry and wet ears. This is a hospital based, observational, descriptive and comparative study. Total 246 patients enrolled in the study. Two groups were created with 123 patients in each group. One included dry ears and another included wet ears. All patients had mucosal type of chronic otitis media. They all underwent Type I tympanoplasty. Graft uptake rate and hearing was compared between both groups. The overall success rate (graft uptake) was 91.06% (224). The success rate in dry ear group was 93.50% (115) and in wet ear group it was 88.62% (109). This study concluded that there is no added advantage of drying the ear rather the delay in treatment increases morbidity and drop outs in Indian scenario.

Characteristics and prognosis of ear fullness feeling in patients with all-frequency sudden deafness

Objective: The characteristics and prognosis of ear fullness feeling in patients with all-frequency sudden deafness were explored. Method: 104 patients (104 ears) with unilateral all-frequency sudden deafness were collected in study from June 2015 to March 2019, including 50 males and 54 females, the mean age ranged from 23-65 years, and the disease duration ranged from 1-9 days. Of those, 56 patients accompanied with the feeling of ear fullness (FEF) were enrolled into'the ear fullness group', and 48 patients without FEF were included in'the without ear fullness group'. Patients' treatment strategy followed the Chinese Medical Association Guidelines for the diagnosis and treatment of sudden deafness (2015). Moreover, VAS scale scores and subjective grading of FEF were acquired in patients with FEF. We analyzed the clinical characteristics and prognosis of FEF with SPSS 23.0 software. Results: There were no differences between the two groups in terms of age, gender, duration of disease, the side of deaf ear, degree of hearing loss, and auditory brainstem evoked potential results (age,t=1.566; gender,χ(2)=0.001; duration, t=0.057; side,χ(2)=0.033; degree of hearing loss Z=-0.180; ABR,χ(2)=0.001;all P>0.05) . There was a positive correlation between the subjective grading of FEF and the degree of hearing loss in patients with FEF (r=0.599, P<0.001) . The total rate of hearing improvement following one month of treatments in patients with FEF vs with no FEF was 35/56(62.5%) vs 28/48(58.3%) (Z=-0.641, P=0.521). After one month of treatment, the total effective rate of FEF was 94.6%(53/56), and the improvement of FEF had nothing to improvement of hearing (r=0.040, P=0.769) . Conclusions: The degree of hearing loss is positively correlated with the degree of FEF in patients with all-frequency sudden deafness. Hearing recovery is not related to FEF. The recovery effect of FEF is good, and has no correlation with hearing recovery.

The evaluation of prognostic factors in endoscopic cartilage tympanoplasty.

The aim of the present study was to evaluate the prognostic factors that may affect the success in endoscopic cartilage tympanoplasty and determine the outcomes of endoscopic cartilage tympanoplasty. This study included 312 patients who underwent transcanal endoscopic type I cartilage tympanoplasty. The effects of sex, the affected side, the size of the perforation, the location of the perforation, the absence of myringosclerosis, external ear canal protrusion, the condition of the contralateral ear, and surgical experience on the rate of graft success and hearing improvement were investigated. The affected side, sex, location of the perforation, myringosclerosis, the condition of contralateral ear, and surgical experience did not significantly affect the surgical success (p > 0.05). However, the size of perforation and ear canal wall protrusion were significantly related to both functional and anatomical success (p < 0.05). Endoscopic transcanal type I cartilage tympanoplasty can be performed with a high anatomical and functional success rate. However, surgeons should be more careful and design a case-specific operation strategy in patients with external ear canal anterior wall protrusion and large perforations.

Acute sensorineural hearing loss in hemodialysis patients

Background: Approximately, 30–40% of patients experienced hearing loss under regular hemodialysis.Objective: This study reviewed our experience on treating acute hearing loss in patients under regular hemodialysis over the past two decades.Methods: Twenty-six patients having acute hearing loss under hemodialysis were divided into two groups based on their etiologies. Sixteen patients (16 ears) with sudden sensorineural hearing loss (SSHL) were assigned to Group A and 10 patients (13 ears) with endolymphatic hydrops (EH) were assigned to Group B.Results: No significant difference was noted between Groups A and B, regardless of hemodialysis duration, clinical manifestation, underlying systemic diseases, blood examination, and vestibular test battery. In contrast, serum osmolality was significantly lower in Group B (292 ± 11 mOsm/kg) than in Group A (310 ± 11 mOsm/kg). Furthermore, Group B (40 ± 14 dB) had better mean hearing level than Group A (87 ± 21 dB) in the initial audiogram, and a higher hearing improvement rate (69%) than Group A (19%).Conclusions and significance: Both SSHL and EH are major causes for precipitating acute hearing loss in hemodialysis patients. Compared to SSHL, the less deteriorated MHL and lower serum osmolality in EH provide two clues for differentiating acute hearing loss in hemodialysis patients.

Healthy lifestyle consultation based on traditional Chinese medicine versus routine patient education in the treatment of idiopathic sudden sensorineural hearing loss after failure of systemic therapy: study protocol for a clinical randomised trial

BackgroundIdiopathic sudden sensorineural hearing loss (ISSNHL) is a major cause of deafness. Despite the advances in systemic therapy, some cases of ISSNHL are untreated, because the exact ISSNHL aetiology is unclear. Traditional Chinese medicine (TCM) has been used to treat diseases for thousands of years and is popular and widely practiced in Asia. TCM includes guidance on a healthy lifestyle. In recent decades, the relationship between lifestyle and disease has been emphasised; an unhealthy lifestyle may lead to illnesses. Thus, this study aims to compare the efficacy of lifestyle modification based on TCM with the usual consultation of ISSNHL after failure of a 2-week systemic therapy to provide a scientific basis for clinical decisions.MethodsThis study is a clinical randomised trial that involves 56 patients diagnosed with ISSNHL but who have had incomplete recovery after initial management (at least 2 weeks of routine Western medical treatment). The study is performed in accordance with the sudden hearing loss clinical guideline of the American Academy of Otolaryngology–Head and Neck Surgery, published in 2012. Participants are randomly distributed into two groups: the healthy lifestyle modification group based on TCM and the control group (1:1 ratio). Patient follow-up lasts for 3 months. The primary outcome measure is the effective rate of hearing improvement, which is defined as the proportion of patients with at least 15 dB of improvement in the average thresholds of hearing loss frequency. The secondary outcome measures are improvements in word recognition score, Tinnitus Handicap Inventory and visual analogue scale for ear blockage and dizziness. Assessments are made at baseline and after lifestyle modification for 1 and 3 months.DiscussionThe efficacy of healthy lifestyle modification based on a TCM programme for patients with ISSNHL with incomplete recovery after failure of initial systemic therapy is determined in this trial. Positive results will provide clinical evidence on the effects of a TCM-based healthy lifestyle, which could be recommended as salvage therapy for patients with ISSNHL.Trial registrationChinese Clinical Trial Registry, ChiCTR-INR-17011459. Registered on 22 May 2017.

A Comparative Study of Outcomes of Type I Tympanoplasty with or without Fibrin Glue

Introduction:&#x0D; Various materials have been used in tympanoplasty to ensure the adherence of the graft with the remnant tympanic membrane. This study aims to compare the clinical outcomes of type I tympanoplasty done with and without fibrin glue.&#x0D; Materials and Methods: &#x0D; This is a prospective comparative study conducted in a tertiary care centre between August 2014 and July 2016. A sample size of 70 patients was used. The patients were randomly divided into two groups – Group A and Group B. Patients in group A underwent tympanoplasty with fibrin glue and patients in group B underwent tympanoplasty without fibrin glue. The patients were followed up for 6 months and the postoperative hearing improvement and graft uptake rates were compared.&#x0D; Results:&#x0D; The pre-operative mean pure tone average for group A was 34.33±7.3dB; it improved to 22.14±6.5 at the end of 6 months. In group B, it improved from 34.25±8dB to 22.64±7.4dB at the end of 6 months. There was no statistical significance in hearing improvement between both the groups. Though there was no statistically significant difference in the graft uptake rates between group A (94.3%) and group B (91.4%), fibrin glue had better outcomes with larger perforations.&#x0D; Conclusion:&#x0D; The use of fibrin glue in tympanoplasty is safe and it has a particular advantage in the graft uptake in subtotal perforations.

Comparative study of graft materials used in myringoplasty

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Various graft materials are used for myringoplasty in practice. Present study was done to compare the hearing improvement and graft uptake rate in patients with inactive mucosal type chronic otitis media with central perforation undergoing myringoplasty using either of the two graft materials: temporalis fascia and conchal perichondrium.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; Patients with tubotympanic type of chronic suppurative otitis media were selected from patients attending the ENT OPD of SMGS Hospital, Government Medical College, Jammu between July 2016 to March 2018. This study included 100 patients out of which 50 were subjected to myringoplasty with temporalis fascia grafting (Group 1) and remaining 50 to conchal perichondrium grafting (Group 2) using underlay technique. The comparative study was done on following parameters-graft uptake and audiological outcome. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; 82% patients were of age less than 30 years. The overall male: female ratio was 1.3:1. In Group 1, 76% had gain of 15 db while 12% had gain of &amp;gt;15 db. In Group 2, 72% had gain of 15 db and 8% had gain of &amp;gt;15 db. The graft was intact in 84% patients. 12% of Group 1 patients, showed residual perforation whereas it was 20% in Group 2 patients.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; The study showed that: the temporalis fascia graft is better than conchal perichondrial graft for closure of perforations in inactive mucosal type of chronic otitis media with central perforation because of maximum hearing improvement and minimal failure rate in group receiving temporalis fascia graft.&lt;/p&gt;

PO171 Barriers to the Use of Cardiovascular Polypills In India: A Mixed-Methods Study

To evaluate the effect of intratympanic steroid injection frequency on hearing outcomes for patients with idiopathic sudden sensorineural hearing loss.A retrospective chart review was performed from 2007 to 2015 at a neurotology tertiary referral center. Adults who met academy criteria for idiopathic sudden sensorineural hearing loss within two months of onset and negative imaging were grouped based on injection frequency. Injection schedules were every 1–4 (group 1), 5–10 (group 2), or 11–30 (group 3) days. All patients had at least two injections with Dexamethasone 10 mg/ml. All patients had pre- and post-injection audiograms.Seventy patients met inclusion criteria (group 1, n = 21; group 2, n = 29; group 3, n = 20). There was no significant difference between group demographics or baseline audiometric data. Mean gains were significant and similar between groups for pure tone average (group 1 = −23.6 ± 22.0 dB; group 2 = −19.7 ± 18.4 dB; group 3 = −24.9 ± 24.7 dB; p = 0.67) and word recognition score (group 1 = +26.3 ± 34.8%; group 2 = +23.3 ± 29.9%; group 3 = +33.4 ± 28.9%; p = 0.53).Frequency of intratympanic steroid injections does not significantly affect hearing outcomes. Following injection therapy, hearing outcomes improved regardless of prior or concomitant oral steroid regimen. Earlier time to initiating injections yielded a higher rate of hearing improvement. Long term hearing outcomes >6 months did not show significant additional improvement.

The outcomes comparison between autologous incus and titanium PORP in Austin A and C type ossicle defect cases

Objective: A series of otitis media patients with Austin A and C type ossicles defects received ossicular chain reconstruction surgery using either autologous incus or titanium partial ossicular replacement prosthesis (PORP).The hearing outcomes and exclusion rate of prosthesis were compared between these two groups. Method: One hundred and seventy-six patients with chronic otitis media underwent ossiculoplasty in our hospital during 2016-2017. These patients were divided into 2 groups: group A consisted of those receiving autologous incus replacement (n=85), and group B consisted of those receiving titanium PORP (n=91). All the patients received CWD mastoidectomy and ossiculoplasty in one stage and were followedup in postoperative 3, 6 and 12 months. Result: The postoperative hearing improvement rates in group A and B were 85.88% and 92.31%, respectively, and there was no statistical difference. No statistical difference of the postoperative hearing improvement rates was observed between Austin A and C type in 2 groups. Three cases (3.29%) had ossicle exclusion in B group, and 0 case in A group, which was not statistical different (P>0.05). Conclusion: Patients receiving ossicular chain reconstruction surgery using autologous incus show similar hearing outcomes as those using titanium PORP. The risk of prosthesis exclusion is lower for autologous incus than titanium PORP. The residual handle of malleus has no obvious influence on the postoperative hearing improvement.

A Prospective Comparative Study between Dry and Wet Tympanoplasty

Abstract Background Tympanoplasty is the well-established procedure for closure of perforations of tympanic membrane. Study Design This study was a prospective comparative study. Objective The objective of this study was to compare the hearing improvement and graft uptake rate between dry and wet tympanoplasty performed on tubotympanic type of chronic suppurative otitis media. Materials and Methods One hundred forty patients with tubotympanic type of chronic otitis media were selected and categorized into dry and wet ears. Tympanoplasty was performed using temporalis fascia by underlay technique in all cases. Postoperatively, graft uptake rate and hearing improvement were analyzed. Results The graft uptake rate was equal in both dry and wet ears, which was statistically insignificant. There was no statistically significant difference in the hearing improvement between the dry ears and wet ears (χ – 2.39, p = 0.122). Conclusion Factors such as age, sex, and status of the contralateral ear and wet ear did not have any impact on the postoperative graft uptake of tympanoplasty. There was no difference in the graft uptake between the dry and wet ears and there was no statistically significant difference between hearing improvement in both and wet ears.

The effect of intratympanic steroid injection frequency in idiopathic sudden sensorineural hearing loss

PurposeTo evaluate the effect of intratympanic steroid injection frequency on hearing outcomes for patients with idiopathic sudden sensorineural hearing loss. Materials and methodsA retrospective chart review was performed from 2007 to 2015 at a neurotology tertiary referral center. Adults who met academy criteria for idiopathic sudden sensorineural hearing loss within two months of onset and negative imaging were grouped based on injection frequency. Injection schedules were every 1–4 (group 1), 5–10 (group 2), or 11–30 (group 3) days. All patients had at least two injections with Dexamethasone 10 mg/ml. All patients had pre- and post-injection audiograms. ResultsSeventy patients met inclusion criteria (group 1, n = 21; group 2, n = 29; group 3, n = 20). There was no significant difference between group demographics or baseline audiometric data. Mean gains were significant and similar between groups for pure tone average (group 1 = −23.6 ± 22.0 dB; group 2 = −19.7 ± 18.4 dB; group 3 = −24.9 ± 24.7 dB; p = 0.67) and word recognition score (group 1 = +26.3 ± 34.8%; group 2 = +23.3 ± 29.9%; group 3 = +33.4 ± 28.9%; p = 0.53). ConclusionsFrequency of intratympanic steroid injections does not significantly affect hearing outcomes. Following injection therapy, hearing outcomes improved regardless of prior or concomitant oral steroid regimen. Earlier time to initiating injections yielded a higher rate of hearing improvement. Long term hearing outcomes >6 months did not show significant additional improvement.

Acupuncture as an early treatment for idiopathic sudden sensorineural hearing loss (ISSNHL) patients with flat or high-frequency drop audiograms: study protocol for a randomized controlled trial

BackgroundIdiopathic sudden sensorineural hearing loss (ISSNHL) is a common form of deafness. Acupuncture has been used as a salvage therapy for ISSNHL in China since 200 BCE. However, the efficacy of acupuncture has not been confirmed in strictly controlled trials. We designed a randomized controlled clinical trial to evaluate the efficacy and long-term effects of acupuncture in patients with early ISSNHL.Methods/DesignIn this randomized controlled clinical trial, we will enroll 124 participants with ISSNHL diagnosed 2 to 4 weeks prior to enrollment, who have shown little hearing improvement after routine Western medical treatment (i.e., corticosteroids). 62 of these participants will have flat audiogram and the other 62 will have a high-frequency drop audiogram; they will all take Methycobal while half of the flat type and half of the high-frequency drop type will also receive acupuncture treatments for 4 weeks in a four-group design. The primary outcome measure will be the effective rate of hearing improvement (defined as the proportion of patients with at least 15-dB improvement in the hearing loss frequency band). The secondary outcome will measure the improvements in Pure Tone Average, Word Recognition Score, and Tinnitus Handicap Inventory. The assessments of the participants will be made at baseline, after treatment (week 4), and at follow-up (week 28).DiscussionThis study aims to explore the efficacy and long-term effects of acupuncture in patients with ISSNHL. This study will be a randomized controlled trial with strict methodology and few design deficits. If our study yields positive results, acupuncture could be recommended as a salvage therapy for patients with ISSNHL.Trial registrationChinese Clinical Trial Registry, ChiCTR-ICR-15006787. Registered on 12 July 2015.

Modified Siegel's criteria for sudden sensorineural hearing loss: Reporting recovery outcomes with matched pretreatment hearing grades

BackgroundSudden sensorineural hearing loss (SSNHL) is an emergency clinical otology condition defined as hearing loss greater than 30 dB over three consecutive frequencies within 72 h. We aimed to integrate pretreatment hearing grades with reports of treatment recovery outcomes of SSNHL using the modified Siegel's criteria. MethodsThis was a retrospective cohort study comprising 110 patients with SSNHL seen between January 2014 and January 2015. The patients were treated with combined systemic and intra-tympanic steroid therapy. The audiometric results were recorded using the modified Siegel's criteria, including pretreatment hearing grades 1–5 (grade 1: hearing threshold under 25 dB, grade 2: hearing threshold 26–45 dB, grade 3: hearing threshold 46–70 dB, grade 4: hearing threshold 71–90 dB, grade 5: hearing threshold over 90 dB) and hearing recovery outcomes, consisting of complete recovery (CR), partial recovery (PR), slight improvement (SI), no improvement (NI) or non-serviceable ears (NS). Patients were further assessed based on the treatment modality (initial or salvage treatment) and duration of the treatment delay. ResultsHearing improvements (CR + PR + SI) were seen in 56 patients. Patients with pretreatment hearing grade 3 had the highest improvement rate (88.2% or 30/34). Patients who received the combined steroid therapy as the initial modality had a better overall hearing improvement rate than did the salvage group. Treatment within the first 14 days yielded a better hearing improvement rate than did late treatments of more than 14 days, especially in patients with a pretreatment hearing grade of 5. ConclusionUsing the modified Siegel's criteria, we report the hearing recovery outcomes with matched pretreatment hearing grades of patients with SSNHL treated with combined intra-tympanic steroid therapy. Our results show the prognostic significance of pretreatment hearing grades in patients with SSNHL.

Analysis of related factors of coins foreign bodies crossing the esophagus in 204 cases of children

Objective:To evaluate the effect of systemic and intratympanic dexamethasone combination therapy on sudden deafness.Method:A total of 98 patients randomly divided into three groups: an intravenous corticosteroid (systemic corticosteroid monotherapy group); an intratympanic corticosteroid (IT monotherapy group); and a combination therapy group (IT plus systemic combination group). All patients were treated additionally with ginkgo-damole and mecobalamine and proton pomp inhibitor. An audiometry was performed before and after the therapies in all patients. Result:Of the total of 98 patients, 39 were receiving systemic corticosteroids, 28 received intratympanic(IT) corticosteroids, and 31 were receiving a combination of the two. A total of 65 patients (66.3%) responded positively to corticosteroid therapy. No significant differences were observed between the three groups (systemic group, IT and combination therapy group) in their overall response to treatment (P=0.61). Patients who suffered from concomitant tinnitus and dizziness responded less positively to the treatment (P=0.00）. Positive family history of SSNHL seems to be negative prognostic factors in the response to treatment (P=0.02).The response to treatment was not related to the initial severity of hearing loss (P=0.68) and pattern (P=0.28). Conclusion:This study did not find any difference in the rate of hearing improvement between systemic, intratympanic, and combined corticosteroid therapy for sudden hearing loss.

Glomus tympanicum: Clinical presentation, management and outcomes

Objective: The objective of the study is to describe the clinical presentation, management, and outcomes of glomus tympanicum (GT) Grade 1–3 (based on Glasscock Jackson staging). Materials and Methods: This is a retrospective chart review of five patients who presented with GT (Grade 1–3) over a period of 4 years to a tertiary hospital. All of them had undergone tumor excision without preoperative embolization. Details of clinical features, diagnostic protocol, surgical approach based on grade of tumor, tumor control, treatment complications, and follow-up results were noted and analyzed. Results: All five patients presented with unilateral hearing loss and tinnitus. Imaging done was magnetic resonance imaging with gadolinium of the brain and high-resolution temporal bone computed tomography. Three patients had transmastoid facial recess approach and one had transcanal approach for tumor removal. One patient had canal wall down mastoidectomy. The average follow-up was 34.8 months. Symptomatic improvement in pulsatile tinnitus was observed in all patients. Hearing remained the same in 1 patient and improved in 4 patients. One patient presented with cholesteatoma 1 year postsurgery. None of the patients had recurrence/residual tumor. Conclusions: GT Grades 1–3 can be managed successfully without preoperative embolization. This gives satisfactory results with respect to hearing improvement and recurrence rates.

Different states of otitis media were retrospectively analyzed of myringoplasty

Objective:Through analysis of the tympanic membrane perforation rate and hearing improvement rate with chronic suppurative otitis media (CSOM) by myringoplasty,to observe the effect of different preoperative conditions such as middle ear lesion,eustachian tube (ET) function and infection status on the postoperative curative effect.Method:Retrospective analysis of EENT Hospital of Fudan University from January 2012 to November 2016 during the 203 cases (203 ears) with clinical data of myringoplasty: according to intraoperative exploration of the presence of purulent secretions in the tympanic cavity,divided into infection active group and infection quiescence group; according to the preoperative results of the function of ET with acoustic impedance test divided into dysfunction or good group; according to the preoperative temporal bone HRCT suggested that the middle ear (mastoid cells,tympanic antrum and tympanic cavity) with or without soft tissue density,divided into the group with no focal lesion and the group with focal lesion. Review endoscopy and pure tone audiometry after 3 to 6 months. Using SPSS 19.0 statistical software to compare the differences among them of tympanic membrane perforation rate and hearing improvement rate.Result:Single factor analysis: ①The infection quiescence group of tympanic membrane perforation rate was 11.93%(13/109),higher than the infection active group ［8.51%(8/94)］; the infection quiescence group of hearing improvement rate was 75.23%(82/109),below the infection active group ［79.79%(75/94)］,no statistically significant differences of them (P>0.05).②The group with dysfunction of ET of tympanic membrane perforation rate was 14.06%(9/64),significantly higher than the group［4.04%(4/99)］with good function ET,with statistical difference of them (P<0.05); the group with dysfunction of ET of hearing improvement rate was 76.56% (49/64),lower than the group［81.82%(81/99)］with good function of ET,no significant difference of them (P>0.05).③The group with no obvious lesion of tympanic membrane perforation rate was 9.09% (10/110),lower than the group ［11.83%(11/93)］with focal lesion; the group with no obvious lesion of hearing improvement rate was 78.18% (86/110),higher than the group with focal lesion ［76.34%(71/93)］,no significant difference of them (P>0.05).Multivariate analysis: ①There was a significant correlation of postop-erative tympanic membrane perforation rate with preoperative ET functi-on (P<0.05).There was no significant correlation of the postoperative tympanic membrane perforation rate with the infection status and the temporal bone HRCT images in the middle ear lesions (P>0.05).②There was no significant correlation of the postoperative hearing improvement rate with the infection status,the ET function and the temporal bone HRCT images in the middle ear lesions (P>0.05).Conclusion:Dysfunction of ET and localized lesions of the ear were more common in infection active;the accumulation of purulent exudate on the surface of the tympanic mucosa and localized lesions of the middle ear did not affect the healing rate of the tympanic membrane and the hearing improvement rate; ET function is one of the most important factors that affect the healing rate of tympanic membrane after operation,the patients with ET dysfunction are more likely to affect tympanic membrane perforation,but does not affect the hearing improvement rate.

Analysis of curative effect on chronic suppurative otitis media by tympanoplasty with or without mastoidectomy

Objective:Analysis of perforation rate and hearing improvement rate of patients with chronic suppurative otitis media after operation, to observe the effect of tympanoplasty with or without mastoidectomy.Method:Retrospective analysis the clinical data of EENT Hospital of Fudan University from January 2011 to December 2016, 167 cases (ears) by tympanoplasty. According to the surgical approach were divided into simple tympanoplasty in 108 cases (group A), tympanoplasty with mastoidectomy in 59 cases(group B)(CWU in 23 cases, IBM in 11 cases, CWD in 25 cases). Endoscopy and pure tone audiometry after 3 to 6 months, using SPSS19.0 software to compare the difference of tympanic membrane perforation rate and hearing improvement rate. Result:The tympanic membrane perforation rate of group A and group B were 8.33%(9/108) and 5.08%(3/59),there was no significant difference(χ²= 0.604, P> 0.05). The hearing improvement rate of group A and group B were 83.33%(90/108) and 77.97%(46/59), there was no significant difference (χ²= 0.727, P> 0.05).Conclusion:For chronic suppurative otitis media with lesions confined to the mastoid and tympanic sinus, the removal of mastoid lesions in the treatment of tympanic membrane healing and improvement of hearing can not achieve better results than simple tympanoplasty.

Differences in myringoplasty between endoscopic and microscope

Objective:The intraoperative and postoperative clinical indexes of myringoplasty performed by endoscope or by microscope were collected retrospectively, the differences between the two different surgical methods were analysized. Method:Retrospective analysis of the clinical data of 70 cases (70 ears) udergoing myringoplasty in the department of Otolaryngology-Head and Neck Surgery, at the Second People's Hospital of Kashi from June 2014 to August 2015. According to the surgical approach cases were divided into two groups, 30 cases in group A by endoscopic myringoplasty and 40 cases in group B by microscope myringoplasty. The operation time, blood loss, postoperative dry ear time, wound healing scar hyperplasia, tympanic membrane perforation rate and hearing improvement rate were compared between the two groups, and SPSS 19.0 statistical software was used to analyze the differences between the two groups. Result:The operation time: Group A had an average of (35.23±6.38)min, less than group B (42.60±7.97)min, with statistical difference (P<0.05). The intraoperative blood loss: the average of group A was (7.33±2.11)ml, less than group B (17.93±3.84)ml, with statistical difference (P<0.05). The postoperative dry ear time more than 1 month: group A was 40%, lower than Group B (75%), with statistical difference (P<0.05). The postoperative incision healing scar hyperplasia: group A was 0%, lower than group B (5%), no significant difference (P>0.05). The tympanic membrane perforation rate: group A was 3.33%, lower than group B (7.5%), no significant difference (P>0.05). The postoperative hearing improvement rate: group A was 76.67%, lower than group B (80.00%), no significant difference (P>0.05). Conclusion:Compared with the traditional microscope surgery, endoscopic myringoplasty is a minimally invasive surgical technique which can get the same curative effect, but with a shorter operation time, less intraoperative blood loss, dry ear in shorter time , recovery more quickly, beautiful incision and other advantages. So it is worthy of clinical application.

Hyperbaric Oxygen Therapy as Adjuvant Treatment for Idiopathic Sudden Sensorineural Hearing Loss after Failure of Systemic Steroids

We evaluated the outcomes of and prognostic factors for idiopathic sudden sensorineural hearing loss (ISSNHL) treated with adjuvant hyperbaric oxygen therapy (HBOT). A retrospective review of clinical data was performed for 167 patients with ISSNHL who failed to respond to systemic steroids and were treated by adjuvant HBOT at Shizuoka Saiseikai General Hospital. We analysed the clinical outcomes, the averaged 5-frequency hearing level after systemic steroids, patient age, the interval between post-steroids and pre-HBOT, vertigo as a complication, the presence of diabetes mellitus, smoking history, and hypertension. Overall, after HBOT, complete recovery occurred in 16 (9.6%) of the patients, with definite improvement in 16 (9.6%) and slight improvement in 45 (26.9%). The overall rate of hearing improvement was higher in the study group (77/167 cases, 46.1%) than in the control group (52/160 cases, 32.5%; p = 0.021). If performed appropriately, HBOT should be able to improve hearing in many cases unresponsive to initial therapy.