Abstract Otology 2000 A10-2

Aruna Visvanathan M.B., M.S., F.A.G.E.

Vikram Hospital & Ear Research Inst IND-R.S. Puram, Coimbatore

Middle ear effusion (MEE) and atelectasis with eustachian tube dysfunction is a multifactorial, multifaceted disease that manifests in the middle ear, mastoid and eustachian tube. Understanding the mechanisms of this disease, the presentation, and issues involved in management, allows for the most optimal outcomes. Several pioneers including Politzer himself have contributed tremendously to the evolution of the diagnosis and management of this entity. This 10 year retrospective study of 178 patients is from a leading otology research institute in India. It briefly overviews the aetiological mechanisms, the course and clinical presentation, and primarily focuses on the long term results of various surgical modalities and their outcome. The ultimate goal is to treat MEE medically, reserving surgery for the restoration of function and for the eradication of disease. Surgery for an atelectatic tympanic membrane ranges from a spectrum of techniques starting from a ventilation tube insertion to several others. The basic objectives are (1) to reinforce or replace an exceedingly weak tympanic membrane which is usually collapsed and not uncommonly attached to the medial wall of the middle ear, (2) to inspect the middle ear cavity, repair ossicles and lyse adhesions, and (3) to re-establish the middle ear space by placement of a silastic film and cartilage palisades. This study is being presented to evaluate the current status of surgery for middle ear atelectasis, and in the hope of paving the way for even better and newer approaches.