Anatomofunctional results of endoscopic ear surgery in patients with Simple Chronic Otitis Media in the Otorhinolaryngology Service of the Hospital de Clínicas

Abstract

Introduction: Perforations of the tympanic membrane (PMT) represent a serious ear condition that can lead to conductive hearing loss, chronic infections and irreversible damage to the eardrum. Treatment for perforations is surgical reconstruction of the eardrum, known as myringoplasty and / or tympanoplasty.

Objective: To evaluate the results anatomofunctional surgery tympanic perforation closure under endoscopic vision in patients with Chronic Otitis Media Simple of the Department of Otolaryngology at the Hospital de Clinicas.

Methodology: Study observational and descriptive design transversal cross - cut retrospective association. Simple random probability sampling method. The sample size was 52 patients who underwent endoscopic surgery to close the tympanic perforation.

Results: 52 patients were included in the study, of which 63.5% were female and 36.5% male. The average age was 28 years. 88.5% had a diagnosis of unilateral simple chronic otitis media and 11.5% bilateral. Regarding the type of surgery, 65.4% of the surgeries performed were myringoplasty and 34.6% were Type I tympanoplasty; 57.7% were from the left ear and 42.3% from the right side. The grafts used were cartilage with atrial concha perichondrium (48.1%), followed by cartilage with tragus perichondrium (30.8%), and in smaller proportions the temporal muscle fascia (19.2%) and lastly ear lobe fat (1.9). Regarding the data analysis, the association between the type of graft used and the complete closure of the perforation, which was 94.2%, was not found to be significant (p> 0.05). Comparatively, the pre and postoperative audiometric controls show significant differences according to the two-tailed analytical calculation, but the results are not statistically significant (p ›0.05) when comparing the type of graft used.

Conclusion: Almost all of the patients presented complete closure of the perforation at 6 months of control. The pre-surgical tonal audiometry reports presented moderate conductive hearing loss in the majority, while in the post-surgical procedure they presented mild hearing loss and normal hearing loss in the majority.

The most frequently used grafts were cartilage and perichondrium of the tragus and atrial shell, with high anatomical and functional success rates, but without statistically significant differences between them.

There were differences with a tendency to improve the tonal hearing averages between the pre and post-surgical controls, but this difference was not statistically significant when comparing the type of graft.