Vol. 5, Issue 11 (2019)
Investigation on chronic supportive otitis media with comparative treatment between myringoplasty and cortical mastoidectomy: A study in Mymensingh medical college, Bangladesh
Author(s): Farid-Al-Hasan, Md. Zahidul Islam
Abstract: Introduction: Chronic otitis media is an inflammatory process of the mucoperiosteal lining of the middle ear space and mastoid. Infection of the middle ear has been a problem encountered in the human race, and is as old as humanity itself. Chronic suppurative otitis media (CSOM) is one of the most common causes of ear infection in developing countries particularly in South-east Asian countries. Chronic middle ear disease is a major problem in India especially in the rural areas. It is estimated that 6% of Indian population suffers from chronic ear disease. Objectives: To Find out Investigation on Chronic Supportive Otitis Media with Comparative Treatment between Myringoplasty and Cortical Mastoidectomy. Materials and Methods: The Prospective study Department of ENT, Mymensingh Medical College Hospital during October 2014 to July 2019 and 50 patients Sample size. For all patients Diagnostic nasal endoscopy was done and CT scan paranasal sinuses were taken for patients with sinusitis. If septic foci found patients were taken up for endoscopic sinus surgery and disease cleared. Allergic symptoms were treated with steroid nasal spray and antihistamines.Culture and sensitivity of ear discharge was done and treated with appropriate antibiotics. Patients were given medical treatment for 3-4 weeks, and once the evidence of response obtained patients were randomly selected by an unrelated personnel and put into either group I i.e. cortical mastoidectomy with myringoplasty or group II i.e. Myringoplasty alone.The selected cases were made to undergo appropriate investigations. Routine blood investigations like Hemoglobin, total and differential count, bleeding and clotting time, chest x-ray, ECG and urine investigations were done for all patients. Observations: In our study total number of patients was fifty. Out of which 25 patients were in cortical mastoidectomy with tympanoplasty group (Group I), of which 13 were males and 12 were females. The other 25 patients belonged to myringoplasty only (Group II) 14 males and 11 females in that group. Maximum number of patients belonged to 18 to 30 years range. Youngest patient was 18 years and oldest patient was 56 years. The population we cater mostly belongs to low socio economic strata, where in chronic otitis media is more common. The middle and high class population together constituted only 8% and 16% in group 1 and group 2 respectively where as low socioeconomic population was 92% in group 1 and 84% in group2 in our study. In both the groups maximum patients had normal mucosa. 20% of patients in either group had polypoidal middle ear mucosa. 28% in group I and 32% in group II had congested mucosa. In our study under group II, graft take-up in bilateral disease had a success rate of 85% and in unilateral disease it was 96%. In cortical Mastoidectomy with Myringoplasty group the success rate was 100% for both set of patients. Conclusion: Cortical Mastoidectomy combined with Myringoplasty enhances the efficacy of graft uptake and the surgical success rate by complete clearance of the disease from Mastoid antrum and restoration of the pressure buffering capacity of Middle ear.