Anatomic and Functional Results of Cartilage Type 1 Tympanoplasty in Children and the Evaluation of the Success of Surgery with Parental Perceptions

Objective:This study aims to determine the anatomic and functional results of cartilage Type 1 tympanoplasty in children and to evaluate the success of surgery with parental perceptions.Methods:Only pediatric patients who had undergone cartilage Type 1 tympanoplasty were included in this study. Patients older than 16 years and patients who had otorrhoea during the previous month, chronic otitis media with cholesteatoma and patients who had undergone mastoidectomy or ossiculopasty were excluded. The ‘anatomical’ success was accepted as an intact graft in the last control in the at least 6th month postoperatively. A satisfaction questionnaire with four questions about the perceptual results of surgical intervention was applied to the patients’ parents on the telephone.Results:In total, 44 ears of 41 cases (22 male 19 female) were included in the study. The mean age was 13.2±2.7 (8-16) and the mean follow-up time was 17 (7-36) months. Anatomical success rate was 88.6% (39/44). As a preoperative mean, the pure tone hearing threshold was 30.7±7.7 dB and the postoperative mean pure-tone hearing threshold was 18.8±7.8 dB. Among the operated ears, 88.6% (39/44) of the perforations were treated successfully. Of the 41 paediatric patients’ parents, only 28 (68.2%) could be reached by telephone; nineteen (68%) of the 28 parents contacted thought that the hearing level had improved postoperatively and only 10 parents (35%) stated that his/her child could attend a preoperatively-restricted activity postoperatively.Conclusion:Outcomes of cartilage tympanoplasty in children satisfy both surgeons and parents. Chronic otitis media in children must be managed with surgery as soon as favourable conditions are provided

Determination of Factors That Impact Patient Satisfaction Following Tympanoplasty

OBJECTIVE: The aim of this study was to assess the subjective evaluation of patients postoperatively about their hearing, otorrhea, and tinnitus by using a questionnaire and to determine factors affecting patient satisfaction following tympanoplasty. MATERIALS and METHODS: Patients who underwent tympanoplasty with or without mastoidectomy due to chronic otitis media were included the study. Patients were called by telephone and invited to a control examination and to answer a questionnaire survey. Patients who came to the control examination were asked about any changes in their hearing and the presence or absence of tinnitus and otorrhea. The overall subjective satisfaction of the surgery was measured by visual analog scale (VAS). RESULTS: One hundred forty-seven patients who underwent tympanoplasty with or without mastoidectomy with a mean age 33.32 +/- 11.27 were included the study. There were statistically significant differences between the patients whose grafts were successfully healed versus those not healed, according to VAS score (p<0.001). VAS score was significantly higher in patients whose tinnitus decreased or disappeared (p=0.001) and in patients whose otorrhea completely disappeared (p=0.008). CONCLUSION: Postoperative patient satisfaction must be taken into consideration for the evaluation of the success of tympanoplasty surgery, in addition to objective criteria. Healing of the tympanic membrane, relief of tinnitus, hearing improvement, and relief from otorrhea were highly correlated with patient satisfaction

Osmophobia and olfactory functions in patients with migraine

Olfactory dysfunction and migraine has been associated for a long time. In this study, we planned to compare olfactory functions in patients with migraine and osmophobia with patients having migraine but no osmophobia, in addition with a normal control group using "Sniffin' Sticks'' test. The main distinction of this study is that all qualitative and quantitative properties of olfactory functions; threshold, discrimination and identification, are evaluated separately and jointly. Thirty healthy person aged between 16 and 56 (18 women, 12 men) and 60 migraine patients aged between 15 and 54 (39 women, 21 man) were included in the study. All patients have been inquired about osmophobia and have been assessed with Hedonic tone assessment. Osmophobia has been tested for perfume, cigarette smoke, leather, stale food, soy sauce, fish, spices and coffee smells. Olfactory functions has been assessed with "Sniffin' Sticks'' smell test. Thresholds, discrimination and identification have been determined for each patient. In migraine patients with osmophobia, threshold was 7.75 +/- 2.3, in migraine patients without osmophobia threshold was 8.25 +/- 1.5 and threshold was 10.75 +/- 1.3 for the control group. Discrimination score was 6 +/- 1.2 in migraine patients with osmophobia, 9 +/- 0.8 in patients without osmophobia and was 12 +/- 1.4 in the control group. In migraine patient with or without osmophobia Threshold/Discrimination/Identification (TDI) scores were lower than the control group. The most important parameter in our study is that discrimination scores were especially lower in patients with osmophobia. We believe that this decrease in discrimination in migraine patients with osmophobia; who claim that they smell everything and they are sensitive to all smells, is significant. Further studies about smell discrimination will help better understand some conditions; especially anosmia and hyposmia after upper respiratory tract infections and parosmia