Canal skin ppt Ppt about canal skin removal Thesis

1.  Comparison of tympanoplasty done with removal of
posterior canal wall skin versus tympanoplasty done
with preservation of canal wall skin.
 Department: ENT

2. Chronic Otitis Media
 Chronic Otitis Media is an important cause of
preventable hearing loss, particularly in the developing
world.
 India is among the countries where the prevalence is >
4% and requires urgent attention
 Chronic suppurative otitis media : burden of illness and
management options, WHO, Genewa,2004

3. Perforation of Tympanic
Membrane

4. Tympanoplasty
 Repair of Tympanic Membrane & ossicles
 Type I : When ossicles are normal
 Grafting materials: Temporalis Fascia
Fascia Lata
Vein, Perichondrium

5. Canal skin has to be elevated in
order to see the Tympanic
membrane

6. Practical Problems during
tympanoplasty
 Raising Tympanomeatal flap
 Tears
 Oozing
 Poor view of surgical field
 Exposure is compromized if flap in the field

7. Improved exposure if posterior
canal skin is removed

8. Aims and Objectives
 To compare tympanoplasty done with removal of
posterior canal wall skin versus tympanoplasty done
with preservation of canal wall skin.
 To offer best treatment options to patients and at the
same time maximizing success rates.
 To improve intra operative visualization

9. Inclusion criteria
 All patients undergoing cartilage tympanoplasty with
Temporalis fascia as graft material.
 Adult patients

10. Exclusion Criteria
 Patients undergoing tympanoplasty with use of
cartilage
 Patients with revision surgery

11.  60 adult patients with perforation of tympanic
membrate undergoing tympanoplasty will be selected
for study.
 Half of them will be operated by preserving canal wall
skin completely whereas the other half will be
operated by removing the posterior canal wall skin.
 2 groups will be created.

12.  Time required for surgery will be calculated from
incision to last stitch.
 Average time taken for the surgery will be calculated in
all patients and compared between two groups.

13.  The patients will be followed up regularly at 1 month
and 4 months after surgery to check for graft uptake
and hearing evaluation.
 Pure tone audiometry(PTA) will be done before
surgery to record hearing levels in all patients.
 Post op Audiometry will be done at 4 months follow
up and student t test will be used to compare these
results in both the groups

14.  Appearance of abnormal granulation tissue or
congestion or edema and overall healing of Tympanic
membrane will be recorded.

15.  Microscopy and endoscopy will be used in follow up
visits to record complete closure of perforation of the
tympanic membrane.
 Complete closure of perforation will be marked as
successful graft uptake.

16.  Results will be recorded and analyzed by standard
statistical methods, including p value.

17. Thank you