Mastoidectomy and Tympanoplasty Including Meatoplasty:

When medical therapy is ineffective, tympanoplasty with mastoidectomy is performed to repair middle ear disorders in both the eardrum (tympanic membrane) and the tiny bones of the middle ear (mastoid bone).

Disease Overview:

Chronic otitis media

Chronic suppurative otitis media (CSOM) is defined by a persistent discharge from the middle ear through a tympanic hole after an initial episode of acute otitis media. It is a major source of avoidable hearing loss, especially in impoverished countries.

Chronic suppurative otitis media is caused by a variety of factors, including acute otitis media and eustachian tube obstruction. A flare-up can happen as a result of a cold, an ear infection, or when water gets into the middle ear. Hearing loss and ear drainage are common in people with this condition.

Disease Signs and Symptoms:

Otorrhea and conductive hearing loss are common symptoms of chronic suppurative otitis media. Unless there is an accompanying osteitis of the temporal bone, pain is unusual. The auditory canal is macerated and littered with granulation tissue, and the tympanic membrane is punctured and draining.

White debris in the middle ear, a draining polypoid mass projecting through the tympanic membrane perforation, and an ear canal blocked with mucopurulent granulation tissue are all signs of cholesteatoma.

Disease Causes:

Streptococcus pneumoniae is the most prevalent bacterial pathogen in AOM, followed by nontypeable Haemophilus influenzae and Moraxella (Branhamella) catarrhalis. More than 95 percent of all AOM cases with a bacterial aetiology are caused by these three species.

Diagnosis:

Clinical examination: Chronic suppurative otitis media is generally diagnosed clinically. Drainage is cultured. A CT or MRI is performed when cholesteatoma or other problems are suspected (as in a feverish patient or one with vertigo or otalgia). Intratemporal or cerebral processes may be shown by these procedures (eg, labyrinthitis, ossicular or temporal erosion, abscesses). Biopsies should be taken if patients have chronic or recurring granulation tissue to rule out recurrent neoplasm.

Disease Treatment:

Chronic Suppurative Otitis Media Treatment:

- Tropical Antibiotic drops

- Surgery for cholesteatomas

Patients with persistent central tympanic membrane perforations and marginal or attic holes may consider tympanoplasty. During tympanoplasty, a disrupted ossicular chain can also be repaired.

Mastoidectomy refers to the surgical removal of sick mastoid air cells. Behind your ear lies the mastoid, which is a portion of your skull. It resembles a honey comb and is loaded with bone air cells.

Cholesteatomas must be surgically removed. Because recurrence is prevalent, middle ear reconstruction is generally postponed until 6 to 8 months after a second-look procedure (using an open surgical technique or a small-diameter otoscope).