Tympanoplsty with or without mastoidectmy is highly effective treatment of chronic otitis media in padiatric age...

The study was conducted to assess the prognostic value of different variables on the outcome of a Type first tympanoplasty alone and combined with intact canal wall mastoidectomy in Chronic Otitis Media (CSOM) in pediatric patients.

The Retrospective study.

The Retrospective study was conducted from April 2017 to April 2023, in which200 pediatric patients were assessed in Department of Otorhinolaryngology and Head & Neck Surgery in territory rural health center. In which 140 patients were enrolled our study according to the selective criteria. All 140 patients presented with diminished hearing loss and ear symptoms. The complete Clinical examination, Otoscopic, tuning forks test, and radiological evaluation were done in all patients. Hearing assessments were done by manual pure-tone audiometry for all patients. Those patients who suffered from rhino sinusitis, adenoid hypertrophy, Furunculosis, Otomycosis, cholesteatoma ear, craniofacial dysmorphias and suspicious malignancy of external and middle ear were excluded from study. A Retrospective study of each patient medical record was undertaken, demographic, preoperative and postoperative information was recorded. Manual Pure Tone Audiometric data was recorded according to previously published guideline of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS). Eustachian tube function assessment done by tympanometry of all patients after 12 weeks of surgery. All one forty patients had ear diseases and impaired hearing was identified. All patients were age between 06 yrs and 18 yrs. The patients were divided into two groups, one in which tympanoplasty type first (Group-1) was performed and other intact canal wall mastoidectomy with tympanoplasty type first (Group-2). All the surgeries were performed by post aural approach under general anesthesia. The autologous temporalis fascia was used as graft material in all surgeries and medial graft technique was performed in all cases. The resulting data were recorded for further comparison and analysis. For the purpose of this study, success was defined for each patient using the following three criteria: [5] INTERVENTION: None.

All one forty patients with ear diseases and impaired hearing were selected according to the inclusion criteria. The patients were divided into two groups, one in which tympanoplasty type first (Group-1) was performed and other intact canal wall mastoidectomy with tympanoplasty type first (Group-2). All the patients were followed up for at least 6 months to 5years. Our study shows females, 82 (59%) were more common than males 58 (41%) patients. Ear diseases and hearing loss involved commonly in right ear (76) than the left ear (64). Chronic Suppurative Otitis Media (CSOM) with Tympanic Membrane perforation were found in 130 (93%) cases, Retraction pocket was 6 (4%) and 4 (3%) patients had atelectasis. Ninety-Two patients have age group between 15 years and 18 years of age. The Large central perforation found in 61 patients. The success rate of tympanic membrane healing was very high in the entire groups in our study. 100 percentages healing of T.M. was found in 06 years to 10 years of age groups. Our study shows 96.57% success rate of graft healing in intact canal wall mastoidectomy with type first tympanoplasty and 89.77% show in type first tympanoplasty in pediatric age group. Our study shows 91.30% improve of conductive hearing loss in intact canal wall mastoidectomy with type first tympanoplasty and 88.57% show in type first tympanoplasty in healed graft in pediatric age group. Five out of one forty patients were improving hearing from 50dB-80dB to 30 dB and 35 dB respectively. The overall success rate of the conductive hearing was about 90 percentages. We performed analysis of the predictive variables according to the success criteria of the healing with the normal hearing.