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Year : 2015  |  Volume : 21  |  Issue : 1  |  Page : 37-40

Our experience of unsafe ear

Department of ENT, Melmaruvathur Adhiparasakthi Institute of Medical Sciences and Research, Melmaruvathur, Tamil Nadu, India

Correspondence Address:
Dr. Nagendran Navaneethan
Department of ENT, Melmaruvathur Adhiparasakthi Institute of Medical Sciences and Research, Melmaruvathur - 603 319, Tamil Nadu
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0971-7749.152860

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Aim: To evaluate the commonest presentation and intraoperative findings and significant post operative challenges in patients who underwent modified radical mastoidectomy in Melmaruvathur adhiparasakthi Institute of medical sciences and research. Design: Retrospective study. Materials and Methods: Fifty six patients who underwent modified radical mastoidectomy for unsafe ear disease were included in this study. The study period was from 2009 to 2012.The commonest presentation was evaluated with the history taken from the patient's records. The intraoperative evaluation of primary pathology and its anatomic extension and ossicular status were identified. Common problems we faced postoperatively were documented. Results: Of the 56 patients,thirty eight(68%) were male and eighteen(32%) were female. The age ranged from nine years -fifty years of age. The commonest presentation in this study was foul smelling scanty discharge (75%) and the primary pathology was isolated cholesteatoma (54%). The involvement of mesotympanum, attic, aditus & antrum with primary disease was more than the isolated involvement of attic,aditus and antrum. Stapes erosion was more common than incus erosion in our study. We faced a very rare postoperative complication of delayed facial palsy in one patient who had no facial nerve dehiscence. Conclusion: Good attention given to patients with infrequent, minimal ear discharge helps to identify unsafe ear. In unsafe ear, otologists should be well prepared to face the stapes erosion during surgery. Even though rare, otologists should be aware of delayed facial palsy and be cautious about the past history of herpes simplex and varizella infection and consider antiviral prophylaxis before surgery.

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