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abstract nr.: O105
ANTERIOR TYMPANOTOMY FOR ATELECTATIC EARS: A PRELIMINARY REPORT
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Author:
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N.B. Prahlada, Karnataka ENT Institute & Research Centr, Chitradurga, India |
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Co-author(s):
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H.C. Ramesh, Jayanagar General Hospital, Bangalore, India
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Topic:
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Surgery |
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Keywords:
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Ossiculoplasty, Interlay technique, Atelectatic Ear, Anterior tympanotomy |
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OBJECTIVE: Atelectasis is a common sequel of otitis media with effusion. The surgical management of the atelectatic ear remains controversial and surgery is often delayed until there is a clear indication, such as hearing loss or frank cholesteatoma development, but such delay often necessitates more extensive surgery. Hereby we present a surgical technique which establishes the ventilation of middle ear and mastoid, reconstructs the hearing mechanism and replaces the adherent tympanic membrane.
METHODS: In this randomized prospective study, 42 patients with Grade III and IV retractions were included. These patients underwent Anterior tympanotomy, incus-reposition ossiculoplasty, interlay technique tympanoplsty. All adherent TM with annulus was excised along with any epithelium in the attic and mesotympanum. Tensor tympanic was cut and silicone sheet was placed in the mesotympanum.
RESULTS: 39 of 42 patients were regularly followed with mean follow-up of 2.7 years. 32(76.19%) patients had significant hearing improvement. 2(4.76%) patients had TM perforation and 4(9.52) had various degrees of retraction.
CONCLUSIONS: Various pathogenic theories have been proposed for atelectatic ears. Main cause has been Eustachian tube dysfunction. Many studies have shown that the eustachian dysfunction is temporary. We propose that the atelectatic changes are result of permanent blockage in various ventilation routes of middle ear and mastoid. Anterior tympanotomy and tympanoplasty which help re-establishing these routes can help in the management of Atelectatic ears. More studies are required.
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Presentation preference:
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