Original Research Article
Year: 2018 | Month: June | Volume: 5 | Issue: 6 | Pages: 94-103
A Comparative Study on the Hearing Outcome in Canal Wall down And Intact Canal Wall Mastoidectomy in Chronic Suppurative Otitis Media with Special Reference to Atticoantral Disease
Dr. Sanchita Kalita1, Dr. Shams Uddin2, Dr. Mukul Patar3, Dr. Abhinandan Bhattacharjee4, Dr. Kripamoy Nath5, Dr. Devraj Dey6, Dr. Rohit Tigga7
1Senior Resident (Gauhati Medical College and Hospital), Assam, India
2HOD and Professor (ENT), 4Assistant Professor (ENT), 5Assistant Professor, 7MD Pharmacology
Silchar Medical College and Hospital, Assam, India
3Associate Professor (ENT), Jorhat Medical College and Hospital, Assam, India
6Assistant Professor, Tezpur Medical College and Hospital, Assam, India
Corresponding Author: Dr. Sanchita Kalita
Introduction: Though the major goal of surgery of the middle ear cleft is to render the ear safe and dry by removal of disease; the increasing concern of the hearing outcome of patients have lead to surgeons resorting to techniques with maximum conservation of hearing and at the same time ensuring effective disease clearance. There has been a never-ending debate on the comparison of the two types of mastoidectomy, CWD and ICW, for management of the unsafe variety of CSOM. An attempt has been made by the current study, to contribute to the available literature for the same.
Aims and Objectives: To compare the audiological outcome of patients with Chronic Suppurative Otitis Media (Atticoantral variety) undergoing Canal Wall Down Mastoidectomy and Intact Canal Wall Mastoidectomy.
Materials and Methods: A one-year single institute prospective comparative clinical study was conducted. 60 cases of CSOM (Atticoantral variety), were selected, and depending on the type of mastoidectomy, two equal groups were obtained, 30 patients planned for CWD mastoidectomy, 30 patients planned for ICW mastoidectomy. Pre- and postoperative air and bone conduction threshold were assessed from averaged pure-tone audiometry (PTA) at 500 Hz, 1 KHz, 2 KHz, and 4 KHz. Post operative audiometry was done at 3 weeks, 3 months and 6 months after operation. Audiometric analysis was performed according to the guidelines of American Academy of Otolaryngology-Head and Neck Surgery.
Results: In the preoperative period, patients with ABG ≤30dB was 3.33% in CWD group and 6.67% in the ICW group; in 3 months postoperative period, it was 3.33%(CWD) and 20% (ICW); for 6 months postoperative period, it was 14.81%(CWD) and 34.48%(ICW). From these observations, it was evident that there was a shift of the ABG of patients towards the better hearing range, ICW>CWD. Comparison of patients with ABG ≤30dB between the two surgical groups, showed that the difference was statistically significant at 3 months postoperative period (p=0.0461).
Key words: Mastoidectomy, CWD, ICW, Chronic Suppurative Otitis Media (CSOM), Atticoantral disease.[PDF Full Text]