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Role of nasal surgery in the outcome of tympanoplasty

Journal of Pulmonary Medicine.

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Role of nasal surgery in the outcome of tympanoplasty

This study is aimed to find the efficacy of nasal surgery prior to tympanoplasty in cases of chronic supportive otitis media (CSOM) with tubotympanic type. We have conducted a comparative study at GIMS hospital Karnataka India from Jan 2016 to Feb 2018.

As everyone knows csom is a widespread disease in the developing countries hence it has to be addressed in a very meticulous manner. Although csom has a multifactorial etiology and pathogenesis but the sinonasal foci acts on the Eustachian tube dysfunctioning and in turn act as a predisposing factor for csom. Hence it becomes important to address the nasal pathology prior to the tympanoplasty to avoid recurrence and complete recovery of the csom.

In this study we have total 64 csom patients, who have been grouped in two groups comprising 32 each. Group 1 only tympanoplasty and Group 2 nasal surgery followed by tympanoplasty. In our study Nasal surgery included (septoplasty, conchoplasty and middle meatal antrostomy). Results have been observed in terms of graft uptake, closure of air bone gap, sensorineural hearing loss and residual peforation. In our study it has been observed that

  1. graft uptake rate is 85% in group 1 and 93% in group 2
  2. The average air bone gap has reduced to <30 db in group 1 and <20 db in group 2
  3. No patients had worsening of the present hearing loss neither development of fresh sensorineural hearing loss.
  4. In group 1 and group 2 we had 2 patients each having small residual perforation.

Hence it has been concluded that nasal surgery prior to tympanoplasty plays a very important role in the graft uptake and improvement in hearing by reducing air bone gap in audiometry.

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