Browsing by Author "Moshi, Ndeserua H."
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Item Chronic otitis media(University of Dar es Salaam, 1989) Moshi, Ndeserua H.In this dissertation, 711 Cases of chronic otitis media with cholesteatoma are analysed regarding the various procedures performed with regard to success rates in eradicating the disease and hearing improvement. In regard to myringoplasty, both the age of the patient at operation and the material used were found to influence rates. Best results were obtained in those patients operated between the age of 20 and 40 years in whom antilogous temporalis fascia graft was used. Successful Surgery in chronic otitis media is dependent on eradication of the disease and preservation or improvement of the hearing. In the cases where cholesteatoma was present modified radical mastoiidectomy (MRH) did better, than combined approach tympanoplasty (CAT) in disease eradication. Recurrent cholesteatomas were encountered in 70% of the cases following MRH compared to 64% following CAT. Twenty percent of the CAT procedures had to eventually be converted to pen cavity because of uncontrollable cholesteatoma recurrences. CAT did better than MRM in hearing improvement. In developing countries where ENT facilities are minimal, it is strongly recommended that the operation of choice for chronic otitis media with cholesteatoma should be a well performed MRM.