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      Análisis de tratamiento de la otitis media crónica simple con miringoplastía en el Hospital Barros Luco Trudeau Translated title: Analysis of the treatment of simple chronic otitis media with myringoplasty at Barros Luco Trudeau Hospital

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          Abstract

          Resumen Introducción: La otitis media crónica simple (OMC) es una patología común en nuestra población y hasta la fecha no queda bien claro cuál técnica y material de injerto da mejores resultados. Objetivo: Determinar si existen diferencias en los resultados anatómicos y funcionales al utilizar fascia de músculo temporal (FMT) versus injerto de cartílago de trago (CT) en los pacientes con OMC en que se les realizó miringoplastía en el Hospital Barros Luco Trudeau. Material y Método: Estudio de cohorte no concurrente de datos obtenidos de la revisión de fichas clínicas. Resultados: De 227 fichas, 154 cumplieron criterios de inclusión. En 102 pacientes (66%) se utilizó FMT y en 52 pacientes (34%) CT. Con FMT 38 presentaron reperforación (37%) y 41 presentaron un éxito funcional (40%). Con CT 18 presentaron reperforación (35%) y 22 presentaron un éxito funcional (42%). 38 pacientes presentaban antecedente de tabaquismo activo y de ellos 53% presentaron reperforación, mientras que de los sin antecedentes de tabaquismo solo un 31%, siendo esta diferencia estadísticamente significativa (p < 0,05). Conclusión: No se obtuvieron diferencias estadísticamente significativas entre los resultados anatómicos y funcionales comparando el uso de injerto FMT y CT para el tratamiento quirúrgico de la OMC simple con miringoplastía.

          Translated abstract

          Abstract Introduction: Simple chronic otitis media (COM) is a common pathology in our population, and it is currently unclear, which grafts technique and material gives the best results. Aim: To determine if there are differences in the anatomical and functional results, when using temporal muscle fascia (FMT) or tragus cartilage graft (CT) in patients with COM who underwent myringoplasty at the Barros Luco Trudeau Hospital. Material and Method: Retrospective analytical cohort study of data obtained from clinical records. Results: Of 227 medical records, 154 met inclusion criteria. FMT was used in 102 patients (66%) and CT in 52 patients (34%). With FMT, 38 had reperforation (37%) and 41 had functional success (40%). With CT 18 had reperforation (35%) and 22 had functional success (42%). 38 patients had a history of active smoking and 53% of them presented reperforation, while of those without a history of smoking only 31%, this difference being statistically significant (p < 0,05). Conclusion: No statistically significant differences were obtained when analyzing the anatomical and functional results comparing the use of FMT and CT graft, for the simple surgical treatment of COM with myringoplasty.

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          Most cited references15

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          A multivariate analysis of otological, surgical and patient-related factors in determining success in myringoplasty.

          The aim of this study was to evaluate the effects of smoking and other prognostic factors on long-term surgical outcome and hearing results in myringoplasty.
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            Smoking and tympanoplasty: implications for prognosis and the Middle Ear Risk Index (MERI).

            The objectives of this study are to review the effects of smoking on preoperative middle ear disease severity, long-term surgical outcome, type and extent of surgery required, the need for ossicular chain reconstruction, and the long-term hearing results. A retrospective chart review. The charts of 74 smokers and non-smokers who underwent over-under tympanoplasty were reviewed. An analysis of the disease severity (using the Middle Ear Risk Index [MERI]) at presentation and type of surgery was performed. A review of graft take and delayed failure (late perforation or atelectasis after 6 mo) and audiologic data were performed. Fifteen patients smoked a mean of 20 cigarettes daily for a mean of 15 years. The MERI was well matched for both groups. There was a trend toward smokers having a higher incidence of otorrhea preoperatively and requiring a more extensive surgical procedure. All patients had full take of the tympanic membrane graft at 6 months; however, delayed surgical failure was seen in 20% of non-smokers compared with 60% of smokers (P = .050). No statistically significant difference was seen in hearing outcome. Cigarette smoking is associated with more severe middle ear disease preoperatively. More extensive surgery is often needed in smokers to eradicate the disease. Most significantly, smoking is associated with a threefold increase in the chance of long-term graft failure. Based on the results of this study, the MERI has been revised to include smoking as a risk factor.
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              Comparison of cartilage with temporalis fascia tympanoplasty: A meta-analysis of comparative studies.

              To systematically review the results of type 1 tympanoplasty with temporalis fascia (TF) versus cartilage in patients with chronic otitis media (COM) for graft integration and hearing improvement.
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                Author and article information

                Journal
                orl
                Revista de otorrinolaringología y cirugía de cabeza y cuello
                Rev. Otorrinolaringol. Cir. Cabeza Cuello
                Sociedad Chilena de Otorrinolaringología, Medicina y Cirugía de Cabeza y Cuello (Santiago, , Chile )
                0718-4816
                June 2021
                : 81
                : 2
                : 192-198
                Affiliations
                [2] Santiago Santiago de Chile orgnameUniversidad de Santiago de Chile orgdiv1Escuela de Medicina Chile
                [3] Santiago Santiago de Chile orgnameUniversidad de Chile orgdiv1Departamento de Otorrinolaringología Chile
                [1] Santiago Santiago de Chile orgnameHospital Barros Luco Trudeau orgdiv1Servicio de Otorrinolaringología Chile
                Article
                S0718-48162021000200192 S0718-4816(21)08100200192
                10.4067/s0718-48162021000200192
                b7562c21-3e26-4b93-8448-7a184b6164e1

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 07 October 2020
                : 03 May 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 15, Pages: 7
                Product

                SciELO Chile

                Categories
                ARTÍCULOS DE INVESTIGACIÓN

                miringoplastía,tragus cartilage graft,Otitis media crónica,fascia músculo temporal,injerto cartílago de trago,Chronic otitis media,myringoplasty,temporal muscle fascia

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