Is It Wise to Wait for Ear to Become Dry in Indian Scenario?
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ORIGINAL ARTICLE
Is It Wise to Wait for Ear to Become Dry in Indian Scenario? Rakesh Tiwari1 • Pawan Singhal2 Rajeev Yadav2,3 • Sunita Agarwal2
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Namita Verma2 Beni Prasad2
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Ritu Sehra2
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Received: 30 March 2020 / Accepted: 4 June 2020 Association of Otolaryngologists of India 2020
Abstract 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. Keywords Wet tympanoplasty Tympanoplasty Hearing gain Chronic otitis media Ear surgery
& Pawan Singhal [email protected] 1
Government Hospital, Alwar, Rajasthan, India
2
Department of Otorhinolaryngology, SMS Medical College, 78 A, Lipi Clinics, Vishnupuri, Durgapura, Jaipur, Rajasthan 302018, India
3
Department of Preventive and Social Medicine, SMS Medical College, Jaipur, Rajasthan, India
Introduction Chronic otitis media (COM) is chronic inflammation of the middle ear-cleft, i.e. eustachian tube, middle ear and mastoid air cell system. In COM a permanent tympanic membrane perforation and chronic otorrhea of greater than six weeks duration unresponsive to oral and ototopical medications are present. It is a major cause of deafness in India [1]. It causes serious lifelong consequences when treatment is delayed. Early detection and effective treatment results in a good outcome and possible complications are thus avoided. Surgery is its definitive treatment. Tympanoplasty is one of its surgical treatment modalities (‘‘Tympanoplasty is an operation to eradicate disease in the middle ear and to reconstruct the hearing mechanism, with or without tympanic membrane grafting’’) [2]. Repairing the tympanic membrane perforation provides many benefits in terms of hearing improvement, achieve dry ear, cure of recurrent ear infections and elimination of need to take water precautions. Although being the most common surgical procedure in treating COM, there is always a dilemma in the mind of otologists in performing tympanoplasty on patients with active ear discharge, due to widespread misbelief that the success rate of ear surgeries on wet ears is
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