Efficacy Analysis of Endoscopic Type 1 Tympanoplasty for Chronic Suppurative Otitis Media with Otomycosis.

Ear Nose Throat J

ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China.

Published: November 2024

AI Article Synopsis

  • A retrospective analysis was conducted on 431 patients with chronic suppurative otitis media (CSOM) to evaluate the effects of tympanoplasty, comparing those with otomycosis to those without.
  • The study found similar graft uptake rates (94.57% for those with otomycosis vs. 96.06% for those without) and no significant differences in hearing improvement, as measured by air-conduction thresholds and air-bone gaps.
  • Culture results revealed that the most common fungal infections included specific genera, and overall, CSOM patients with otomycosis can safely undergo tympanoplasty without negatively impacting their surgical outcomes.

Article Abstract

To analyze the clinical effect of tympanoplasty performed for chronic suppurative otitis media (CSOM) patients with otomycosis under the oto-endoscope. A retrospective analysis was conducted on the healing of the tympanic membrane and hearing improvement of 431 CSOM patients who underwent endoscopic type 1 tympanoplasty. The patients with CSOM were divided into the control group ( = 203, without otomycosis) and the trial group ( = 184, with otomycosis). The patients were followed up for at least 3 months. The graft uptake rate and hearing improvement were compared. The graft uptake rate was 94.57% (174/184) in the trial group and 96.06% (195/203) in the control group, indicating no significant difference between the 2 groups. The preoperative and postoperative average air-conduction hearing thresholds of CSOM with otomycosis were 42.68 ± 11.46 dBHL and 33.01 ± 11.51 dBHL, respectively ( = .000). Mean air-bone gap (ABG) reduction values were 3.96 ± 7.20 dBHL and 3.34 ± 7.96 dBHL, respectively. There was no significant difference in the average ABG ( = .420) and average air-conduction hearing threshold ( = .649) between the trial group and the control group after operation. The culture results of the CSOM group with otomycosis showed that the most common fungal genus was (87/173), with 32 cases of mixed infection of fungi and bacteria, and the most common mixed infection of bacteria was (9/32). The failure graft uptake was noticed in 8.8% (5/57) cases in the trial group with postoperative fungal infection and 3.9% (5/127) without otomycosis ( = .289). No significant difference was found in the successful healing rate among age, duration, perforation size, fungal type, postoperative fungal infection. CSOM with otomycosis is not a contraindication for endoscopic type 1 tympanoplasty, and external auditory canal fungal infection does not affect postoperative healing and hearing improvement. Intraoperative repeated rinsing with povidone-iodine may reduce the occurrence of postoperative infection.

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Source
http://dx.doi.org/10.1177/01455613241300891DOI Listing

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