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Evaluating the Eustachian Tube Function in Chronic Suppurative Otitis Media in Reference to its Treatment Outcome | Chapter 9 | Highlights on Medicine and Medical Science Vol. 18

The most essential determinant in the development and persistence of otitis media is tubal dysfunction. Because the beginning pathogenetic variables of Eustachian tube function and middle ear ventilation are still intact, even the most meticulously done surgery will fail if the Eustachian tube failure remains. The medical and surgical evaluation of middle ear disorders must consequently include a measurement of Eustachian tube function.

The goal of this study was to determine Eustachian tube function in a safe kind of chronic suppurative otitis media and compare graft uptake in normal, slightly impaired, and severely impaired Eustachian tube function in a safe type of chronic suppurative otitis media.

Methods: From November 2016 to October 2017, the current prospective study was conducted in the department of otorhinolaryngology and head & neck surgery, SMGS Hospital, Jammu. After receiving approval from the institution's Ethics Committee, the study was carried out. The study included patients who visited the ENT outpatient department. Pure Tone Audiometry and impedance audiometry were used to diagnose patients both clinically and audiometrically. All of the patients had a TOYNBEE test to determine the function of their eustachian tubes. Surgery was considered for an equal proportion of patients with normal, slightly impaired, and severely impaired Eustachian tube function.

Results: Graft uptake was seen in 19 (95%) of 20 individuals with normal Eustachian tube function. 18 (90 percent) of the 20 patients with somewhat reduced Eustachian tube function demonstrated transplant uptake. 13 (65%) of 20 patients with severely reduced Eustachian tube function showed transplant uptake. Pre- and post-operative AB gap mean values compared to normal, partly affected, and severely impaired Eustachian tube functioning. The statistical significance of the comparison is (p 0.001).

Conclusion: Impedance audiometry testing of the ETF is a straightforward, non-invasive method of determining the ETF. As shown in our study, a functional Eustachian tube is a crucial condition for a successful myringoplasty procedure. The ability to anticipate the success of myringoplasty / tymapanoplasty by testing the functions of the Eustachian tube prior to surgery is feasible. It was also decided that a partially functioning Eustachian tube should not be deemed a contraindication to these procedures, as graft absorption and AB-gap closure were good in majority of these cases (90 percent ).

 

Author (S) Details

Sucheta Gupta
Department of Health and Medical education, Government of Jammu and Kashmir, Jammu and Kashmir, India.

Mohit Goel
Department of ENT, Head and Neck surgery, Dr. Rajendra Prasad Government Medical College, Tanda, Kangra, Himachal Pradesh, India.

Padam Singh Jamwal
Department of ENT, Head and Neck Surgery, SMGS Hospital, Government Medical College, Jammu, Jammu and Kashmir, India.


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