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Impact of otorrhoea and ossicular status on the effect of tympanoplasty

Background: The objective of the study was to assess the effect of otorrhoea, osscicular and middle ear status on anatomical and functional results in patients undergoing tympanoplasty with or without mastoidectomy for chronic otitis media mucosal diseaseMethods: This was a prospective study conducted on 100 patients with otological complaints (otorrhoea, hearing loss) attending the out-patient Department of ENT, at Mamata Medical College and Research Hospital, Khammam Telangana state during the period from December 2015 to July 2017. All the patients underwent a detailed general physical, otoneurological evaluation, hearing assessment by pure-tone audiometry prior to surgery. As per MERI the patients were evaluated for factors preoperatively and intraoperatively. Postoperatively the patients were followed up at 3 and 6 months to ascertain the structural (graft take up) and functional (hearing improvement) success.Results: Otorrhoea was the most common complaint observed (48%). As per Belluci's classification of otorrhoea, maximum number of patients (52%) had a dry ear, wet ears (48%) and persistently wet ears (8%). According to Austin-Kartush classification 50 patients had an intact ossicular chain, defects of the incus in 36 patients, defects in both malleus and incus, stapes and incus was seen in 7 patients each. Majority of the patients 79% had normal middle ear status while 21% of them had middle ear effusion present. Majority of the patients belonged to the group of mild risk MERI (l-3) (n=69) patients, moderate risk category MERI (4-6) (n=26) severe risk (7-12) (n=5). Graft uptake was successful in 78 patients and failure in 22 patients. Hearing Improvement was noticed in 78 patients.Conclusion: Otorrhoea and middle ear cleft status have an impact on the success of the tympanoplasty, while ossicular status did not have a significant effect on the outcome.