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Impact of Otorrhea and Positive Cultures on Tympanoplasty Outcomes
Muhamed Masalha1, Lev Shlizerman2, Salim Mazzawi2
1Department of Otolaryngology Head and Neck Surgery, Emek Medical Center, Afula, Israel, Rappaport Faculty of Medicine, Technion-Institute of Technology, Haifa, Israel.
Background:
Chronic suppurative otitis media is a long-standing middle ear infection with a perforated tympanic membrane. Tympanoplasty is the mainstay of treatment. Most surgeons prefer to operate on dry ears; however, this may be difficult to achieve.
Objectives:
To investigate the effect of otorrhea and positive cultures on the outcome of tympanoplasty.
Methods:
This retrospective analysis reviewed patients with chronic suppurative otitis media who underwent tympanoplasty 2008-2015. Patients were divided into three groups: active discharge and bacterial growth, active discharge without bacterial growth, and no ear discharge. Surgical outcomes were compared among the groups.
Results:
Among 101 patients included, 43 ears (42.6%) had discharge preoperatively, 58 (57.4%) were dry. Overall closure rate was 81.2% (82/101). Preoperative active discharge closure rate was 88.3% (38/43) and without discharge 75.9% (44/58). There were 38 positive cultures preoperatively and five negative cultures. Cultures were not obtained in 58 cases. Success rates were 89.5%, 80%, and 75.9%, respectively. No significant difference was found between patients who had positive or negative cultures before the procedure (P > 0.48) or among the three groups (P = 0.25). The most common bacteria were Pseudomonas aeruginosa (n=17), followed by Staphylococcus species (n=10). None was significantly associated with operative failure (P = 0.557). The postoperative air threshold difference was not affected by culture results (P = 0.3).
Conclusions:
Tympanoplasty success rates and postoperative air threshold differences were not affected by the presence of preoperative otorrhea or positive ear cultures. Surgery can be performed even when the ear is not dry.
Insights
Tympanoplasty outcomes are not affected by ear discharge or positive cultures. Surgeons can proceed with tympanoplasty even if the ear is not dry, improving treatment accessibility for chronic suppurative otitis media.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Surgical Outcomes
Background:
- Chronic suppurative otitis media involves persistent middle ear infection and tympanic membrane perforation.
- Tympanoplasty is the primary surgical intervention for this condition.
- Operating on dry ears is preferred but often challenging to achieve.
Purpose of the Study:
- To evaluate the impact of preoperative otorrhea and positive bacterial cultures on tympanoplasty success rates.
- To determine if ear discharge influences surgical outcomes in patients with chronic suppurative otitis media.
Main Methods:
- Retrospective analysis of 101 patients undergoing tympanoplasty between 2008 and 2015.
- Patients categorized into three groups based on ear discharge and culture results: discharge with growth, discharge without growth, and no discharge.
- Comparison of surgical outcomes, including closure rates and air-bone gap, across the defined groups.
Main Results:
- Overall tympanoplasty closure rate was 81.2%.
- Preoperative otorrhea did not significantly impact success rates (88.3% vs. 75.9%).
- Positive bacterial cultures and specific pathogens like Pseudomonas aeruginosa and Staphylococcus species were not associated with significantly different outcomes or postoperative air-bone gap.
Conclusions:
- Tympanoplasty can be successfully performed in the presence of preoperative otorrhea or positive ear cultures.
- Otorrhea and positive cultures do not negatively affect surgical success rates or hearing outcomes.
- These findings support performing tympanoplasty even when the affected ear is not completely dry.
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