Raaj Mohan, Karadi R N, Tht Lathadevi, Bhat Manali Ramana, T Shashikumar
Otolaryngology - Head and Neck Surgery, Shri B. M. Patil Medical College Hospital and Research Centre, Bijapur Lingayat District Educational (BLDE) Association (Deemed to be University), Vijayapura, IND.
Cureus. 2024 Sep 5;16(9):e68706. doi: 10.7759/cureus.68706. eCollection 2024 Sep.
Background Chronic suppurative otitis media (CSOM) is the inflammation of the middle ear mucosa for more than two weeks, resulting in ear discharge. It is associated with hearing loss and the presence of a perforation in the tympanic membrane. Tympanoplasty is performed to place a graft and clear the disease in the middle ear. Despite adequate disease clearance and proper graft placement, graft failure and disease persistence occur due to Eustachian tube (ET) dysfunction. The ET plays a significant role in the ventilation of the middle ear. Hence, this study was conducted to determine the significance of ET size for post-operative graft uptake. Methodology A total of 55 patients with inactive CSOM were included in the study. Their demographic data were recorded. Patients previously operated on for CSOM, cases with traumatic perforation of the tympanic membrane, congenital anomalies (e.g., cleft lip/cleft palate), and atticoantral disease were excluded. Thorough history taking and examination, including otoscopy and examination of the nose, throat, and oropharynx, were conducted. Once the patient was deemed fit for surgery, they underwent tympanoplasty. Intraoperatively, the ET size was measured using the tip of the suction cannulas. They were followed up after three months to assess graft uptake. Results Out of 55 patients included in the study, 42 (76%) had good graft uptake, while 13 (24%) had defects in graft uptake. Graft uptake failed in patients with an ET diameter of <3 mm. Post-operative graft uptake was observed in the majority of patients with a wider ET diameter, ranging between 3 mm and 6 mm, with a statistically significant p-value of 0.00 (0.05), as determined by Pearson's Chi-square test. Conclusion In our study, we found that there is an association between the ET diameter and post-operative graft uptake. Hence, a wider ET may improve middle ear ventilation and play an important role in post-operative graft uptake.
背景 慢性化脓性中耳炎（CSOM）是中耳黏膜炎症持续超过两周，导致耳内流脓。它与听力损失以及鼓膜穿孔有关。鼓室成形术旨在植入移植物并清除中耳疾病。尽管疾病清除充分且移植物放置恰当，但由于咽鼓管（ET）功能障碍，仍会出现移植物失败和疾病持续存在的情况。咽鼓管在中耳通气中起重要作用。因此，本研究旨在确定咽鼓管大小对术后移植物吸收的意义。
方法 本研究共纳入55例静止期CSOM患者。记录他们的人口统计学数据。排除既往因CSOM接受过手术的患者、鼓膜外伤性穿孔病例、先天性畸形（如唇裂/腭裂）以及上鼓室鼓窦疾病患者。进行全面的病史采集和检查，包括耳镜检查以及鼻、喉和口咽检查。一旦患者被认为适合手术，即接受鼓室成形术。术中，使用吸引套管尖端测量咽鼓管大小。术后三个月进行随访以评估移植物吸收情况。
结果 纳入研究的55例患者中，42例（76%）移植物吸收良好，而13例（24%）移植物吸收存在缺陷。咽鼓管直径<3 mm的患者移植物吸收失败。大多数咽鼓管直径较宽（3 mm至6 mm）的患者术后出现移植物吸收，经Pearson卡方检验确定，p值具有统计学意义，为0.00（<0.05）。
结论 在我们的研究中，我们发现咽鼓管直径与术后移植物吸收之间存在关联。因此，较宽的咽鼓管可能改善中耳通气，并在术后移植物吸收中起重要作用。
