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Objectives: To evaluate the opposite ear in patients operated for chronic otitis media (COM). Methods: In a cross-sectional study involving three tertiary hospitals, patients who underwent surgery for COM were examined for abnormalities of the contralateral ear at the time of the surgery. Results: Out of 228 patients, 182 (79.8%) were operated on for non-cholesteatomatous or simple chronic pars tensa perforation of the tympanic membrane (PTP), and 46 (20.2%) for cholesteatoma. 113 (49.56%) patients had normal contralateral ears under oto-microscopic exam. PTP was statistically more prevalent in females than males (F/M:118/64), whereas cholesteatoma was more prevalent in males (21/25). In the PTP group, 82 (45.3%) had normal contralateral ears, whereas patients with cholesteatoma had 31 (67.4%) normal opposite ears ( P  = 0.01). The most frequent abnormal findings in the PTP group were pars tensa perforation and sclerotic plaques, and in the cholesteatoma group were cholesteatoma and pars tensa perforation. Patients with cholesteatoma had significantly lower contralateral ear perforation than patients with tympanic membrane perforation ( P  = 0.02). The most frequent size of eardrum perforation in the contralateral ear of the PTP group was more than 50 percent. No significant difference existed between the large and small perforations for contralateral abnormality. Conclusion: Bilateral pathophysiology seems to be more prominent in PTPs than in cholesteatomas. Tympanic membrane perforation tends to be accompanied by a large perforation. The larger perforation on one side did not predict having more problems on the opposite side.

Objectives To systematically explore the differences in acoustic changes and healing outcomes of tympanic membranes (TMs) with pars flaccida perforation (PFP) and pars tensa perforation (PTP). Methods We created PFPs and PTPs of various sizes in Sprague–Dawley rats, and evaluated TM umbo velocity and hearing function using laser Doppler vibrometry and auditory brainstem response (ABR) measurement before and immediately after perforation. Two weeks later, hearing was reevaluated and TMs were investigated by immunohistochemical staining. Results Small PFPs and PTPs did not significantly affect umbo velocity and hearing function. Large PFPs increased umbo velocity loss at low frequency (1.5 kHz) and elevated ABR thresholds within 1–2 kHz. Large PTP caused significant velocity loss at low frequencies from 1.5 to 3.5 kHz and threshold elevations at full frequencies (1–2 kHz). Two weeks after the perforation, the hearing function of rats with healed PFPs recovered completely. However, high‐frequency hearing loss (16–32 kHz) persisted in rats with healed PTPs. Morphological staining revealed that no increase in the thickness and obvious increase in collagen I level of regenerated par flaccida; regenerated pars tensa exhibited obvious increase in thickness and increased collagen I, while the collagen II regeneration was limited with discontinuous and disordered structure in regenerated pars tensa. Conclusion The hearing loss caused by large PFP limits at low frequencies while large PTP can lead to hearing loss at wide range frequencies. PFP and PTP have different functional outcomes after spontaneous healing, which is determined by the discrepant structure reconstruction and collagen regeneration.

Objective: To assess the graft take rate and hearing gain in trans-canal endoscopic tympanoplasty Study Design: Descriptive study. Place and Duration of Study: Pakistan Naval Ship Hafeez, Islamabad Pakistan, form Dec 2015 to Jun 2018 Methodology: All patients with dry central perforations of >3 months history were included in the study. All Patients with perforations of pars tensa were booked for endoscopic cartilage tympanoplasty. All perforations were divided into four types small, medium, large and subtotal or total based on size of the tympanic membrane perforations. Small perforations involving <25% area of Pars Tensa. Medium perforation are Perforations involving 25-50% of Tympanic membrane. Large perforations include Perforations involving 50-75% of pars tensa. Subtotal or total perforations are defined as perforations with >75% perforation of the tympanic membranes. Wet Ears and perforations involving the Pars Flacida were excluded from the study. Preoperative Audiogram was carried out for all patients and A-B Gap were noted for all groups separately so as the demographic data including age and gender. Success was defined as complete closure of Tympanic membrane perforation at 3 months. All patients were operated with 0 Degree 3mm, 14cm rigid endoscope under general anesthesia. Results: Mean age of patients was. 37 years and standard deviation was 12.34 (range 12-58 years). Out of total 157 cases 81 patients male were males (51%) and 76 patients were females (49). Out of 157 ears operated 146 Perforations healed completely an overall success rate of 92%. Patients with small perforations had 100 percent success...