SEARCH · PubMed Health

Results for “TYMPANOPLASTY”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 91 records · Page 5Linked to original sources

PubMed1994

Type 1 tympanoplasty in children.

OBJECTIVE: To identify factors affecting the surgical success rate and reperforation rate in type 1 tympanoplasty. Controversy continues regarding the advisability of this procedure in young children, largely because of the likelihood of recurrent middle ear disease and eustachian tube dysfunction. DESIGN: Retrospective medical record review of a case series. SETTING: Pediatric hospital that serves both as a primary care and referral center. PATIENTS: All private patients younger than 18 years, undergoing type 1 tympanoplasty from 1985 through 1989, for whom at least 6 months' follow-up was available. Two hundred nine tympanoplasties on 183 patients were included; 22 patients were excluded for insufficient follow-up. MAIN OUTCOME MEASURES: Surgical success was defined by confirmation of an intact tympanic membrane at least 6 months postoperatively. Procedures were deemed long-term successes if the tympanic membrane remained free of perforation to the end of follow-up. RESULTS: The overall short-term surgical success rate was 92%, with 87% of ears remaining free of reperforation to the end of follow-up. If the perforation involved the margin, the surgical success and long-term success rates dropped to 86% and 77%, respectively. Although reperforation was more likely in patients younger than 6 years or in those with contralateral otitis media at surgery, even these groups had long-term success rates of 81% and 74%, respectively. CONCLUSIONS: Tympanoplasty may be considered at any age. Even in young children, there is a high likelihood of return to normal function.

Adolescent↗

PubMed2005

Pressed scar tissue for tympanic membrane grafting in revision tympanoplasty.

OBJECTIVE: Compare the efficacy of pressed scar tissue grafts to standard fascia and areolar tissue grafts for use in tympanoplasty. STUDY DESIGN: A retrospective review of a prospective computerized database of tympanoplasty and mastoid surgeries at an academic, tertiary care practice was performed. Search parameters were set to find all patients who underwent tympanoplasty with or without mastoidectomy with use of various grafting materials for repair of tympanic membrane perforation from 1996 to 2002. All ages were included. Patients with cholesteatoma at the time of surgery were excluded. The short-term graft take rate was evaluated at 30 to 90 days to identify any differences in results using the standard fascia and areolar grafts vs. pressed scar tissue grafts. Other parameters that may have an influence on outcome were analyzed including mastoidectomy, infection, perforation size, perforation location, age of patient, primary vs. revision surgery, number of previous surgeries, postauricular vs. transcanal approaches, and medial vs. lateral grafting techniques. Hearing results were analyzed to see whether the use of scar tissue grafts resulted in equivalent outcomes compared to standard graft materials. RESULTS: There were no statistically significant differences in short-term tympanic membrane closure rates in subjects undergoing surgery using standard fascia/areolar tissue grafts and pressed scar tissue grafts. Hearing results were also statistically equivalent regardless of graft material used. The only parameter that was somewhat associated with successful closure of tympanic perforation was use of the postauricular approach compared to the transcanal approach. CONCLUSIONS: Pressed scar tissue grafts are as efficacious as standard fascia and areolar tissue grafts when used to repair tympanic membrane perforations. Pressed scar tissue graft can be used successfully in cases such as revision tympanoplasty when standard tissue grafts are not available or difficult to obtain. EBM RATING: B-3.

Adolescent↗

PubMed2005

Mediolateral graft tympanoplasty for anterior or subtotal tympanic membrane perforation.

OBJECTIVE: To describe and evaluate the mediolateral graft tympanoplasty for the reconstruction of anterior or subtotal tympanic membrane (TM) perforation. STUDY DESIGN AND SETTING: Retrospective study of 100 patients who underwent the mediolateral graft tympanoplasty at community and tertiary care centers from 1995 to 2001. All patients underwent preoperative and postoperative audiograms. Posterior tympanomeatal flap is elevated same as in the medial (underlay) graft tympanoplasty. Anterior-medial canal skin is elevated down to the annulus. At the annulus, only squamous epithelial layer of TM is elevated up to anterior half of the TM perforation. Temporalis fascia is grafted medial (underlay) to the posterior half of the perforation and lateral (overlay) to the anterior half of the de-epithelialized TM perforation, up to the annulus. Anterior canal skin is rotated to cover the fascia graft and TM perforation as a second-layer closure. Patients were followed for at least 6 months. Outcome was considered successful if the TM is intact. RESULTS: There were 3 failures (97% success rate), attributable to a postoperative infection, anterior blunting, and recurrent cholesteatoma, respectively. There was no significant postoperative hearing loss compared with preoperative hearing. More than 70% of the operated ears had hearing improvement of 0-40 dB (0-10 dB in 19% of ears, 11-20 dB in 44%, 21-30 dB in 7%, and 31-40 dB in 4%) even without ossiculoplasty. With ossiculoplasty using either partial ossicular replacement prosthesis (PORP, 15%) or total ossicular replacement prosthesis (TORP, 11%), there were various degree of hearing improvement from 11 to 30 dB. CONCLUSION AND SIGNIFICANCE: The mediolateral graft method is superior to the traditional medial or lateral graft technique for the reconstruction of large anterior or subtotal TM perforation. This new method should help otologic surgeons to improve outcome of tympanoplasty for anterior or total TM perforation. EBM RATING: C-1.

Audiometry, Pure-Tone↗

PubMed2005

Bacteriemia during mastoidectomy and/or tympanoplasty.

OBJECTIVE: To investigate the risk of bacteriemia development during surgery in patients who underwent mastoidectomy and/or tympanoplasty for chronic otitis media. PATIENTS AND METHODS: A total of 59 patients with chronic otitis media who were undergoing tympanoplasty operation with or without mastoidectomy were enrolled in this study. Smear cultures were obtained from outer ear canal and/or middle ears of all patients before the operation. Venous blood samples were obtained before and after the operation for bacteriologic analysis. Smear cultures were also obtained from the pressure dressing material that was applied during the operation for retrieval of the outer ear canal pressure. RESULTS: There was a 13.5% difference between the outer ear canal and/or middle ear smear cultures and ear pressure dressing smear cultures of the same case. There was no growth in the blood cultures obtained before tympanoplasty in any of the involved cases, however, in 5 (8.4%) of the culture samples obtained immediately after the tympanoplasty operation, there was bacteriemia. In the pressure dressing smear cultures obtained after the operation, 11 patients had microbial growth. CONCLUSION: Risk of bacteriemia should be considered in the preoperative period for the patients undergoing mastoidectomy especially in patients with cardiovascular diseases, this is of importance for the dramatic consequences that might arise after the operation. We also think that bacteriemia is also one of the factors that influences graft success rate.

Adolescent↗

PubMed2001

Hearing results of canal wall reconstruction tympanoplasty for middle ear cholesteatoma in children.

OBJECTIVE: To investigate post-operative hearing results in children with middle ear cholesteatoma, and to analyze the correlation between hearing results and clinical factors and findings before and during the operation. PATIENTS AND METHODS: One hundred and twenty-four ears of 123 children were operated on for middle ear cholesteatoma at the age of 10 years or younger by canal wall reconstruction tympanoplasty and were followed up more than 1 year after the final operation. We evaluated the average air and bone conduction hearing levels at the speech ranges before the first operation (pre-operative hearing) and after the final operation (post-operative hearing). RESULTS: The mean of the average air conduction hearing level of 124 ears was significantly improved from 34.7 to 27.1 dB after the final operation. Among them, 84 ears (67.8%) showed a hearing level of 30 dB or less post-operatively. Post-operative hearing was better in the one-stage group than in the staged group. However, more than one-half of the ears which underwent type IV tympanoplasty in the staged group showed post-operative air conduction hearing level of < or =30 dB. Significant improvement in post-operative hearing was noted in ears with normal middle ear mucosa or middle ear effusion at the final operation. No correlation between hearing improvement and clinical factors such as age, type of cholesteatoma or presence of otitis media with effusion at the first operation was found. CONCLUSIONS: Children with middle ear cholesteatoma at the age of 10 years or younger exhibited good hearing post-operatively. Satisfactory hearing improvement is expected even in ears without the superstructure of the stapes if staged tympanoplasty is conducted. Canal wall reconstruction tympanoplasty for pediatric cholesteatoma was successful in terms of hearing results and the success was unrelated to various clinical factors.

Bone Conduction↗

PubMed1990

Tympano-cartilago-stapediopexy: a method to improve hearing in open technique tympanoplasty.

Canal wall-down technique tympanoplasty was indicated in about 41 per cent of our cases with chronic suppurative otitis media. In this series done during the last four years, of 576 tympanoplasties, 240 cases needed type III tympanoplasty. In 145 cases, myringostapediopexy was carried out using temporalis fascia grafting over the head of the stapes. Tympano-cartilago-stapediopexy was performed in the other 95 cases by using tragal cartilage and perichondrium over the stapes. A comparison between the results of both methods of grafting is discussed. Improvement in hearing was achieved after tympano-cartilago-stapediopexy. This method proved to be suitable for those cases which need open technique tympanoplasty.

Cartilage↗

PubMed1998

Tympanoplasty in children--a prospective study.

Considerable controversy surrounds the subject of tympanoplasty in children. This prospective study looked at the results of type-I tympanoplasty in children. Forty-five children in the age group of five to 14 years were selected for the study. All these cases had a central perforation without any evidence of cholesteatoma. The ear to be operated had to be dry for at least six weeks before surgery. Type I tympanoplasty was performed on these patients with autograft temporalis fascia by either the underlay or overlay technique. The overall success rates in 45 operations evaluated one year post-operatively was 91.1 per cent. The age of the patient had no influence on the success rate. The two factors which adversely influenced the success rate were the presence of near total perforation and bilateral perforations. It was concluded that type-I tympanoplasty has a good chance of success in children regardless of age.

Adolescent↗

PubMedDate not supplied

Evaluation of high-resolution CT after tympanoplasty.

The temporal bones of 28 patients who underwent tympanoplasty were evaluated with high-resolution CT (HRCT). Seventeen patients had undergone tympanoplasty with a columella, used to form an ossicular reconstruction. The incus body was used as the columella in 4 patients and a prosthesis was used in 13 patients. No columella was used in the other 11 patients. After tympanoplasty, CT demonstrated normal appearance in 8 patients. Of the other 20 patients, 16 were diagnosed with chronic otitis media, and 4 were diagnosed with recurrent cholesteatoma on the basis of follow-up CT examinations. Seven underwent reoperation. In all 4 patients with recurrent cholesteatoma, the diagnosis was pathologically confirmed at reoperation. In 1 patient diagnosed with chronic otitis media, the pathological diagnosis was recurrent cholesteatoma. The columellae in 8 of the 17 patients could not be identified on CT because of surrounding soft tissue mass, but in the other 9 patients the condition of the ossicular reconstruction was well demonstrated. Prosthesis dislocation was apparent in 2 patients. We recommend HRCT examination in the follow-up of tympanoplasty patients.

Cholesteatoma↗

PubMed1997

Hearing results with cartilage tympanoplasty.

Cartilage has shown promise as a graft material to close perforations in the tympanic membrane (TM), particularly in cases of advanced middle ear pathology. Although it is similar to fascia, its more rigid quality tends to resist resorption and retraction. However, it is this rigid quality that has led many to anticipate a significant conductive hearing loss when using cartilage to reconstruct the TM. Because little has been reported in the literature comparing hearing results using cartilage with results using other grafting materials, this retrospective study was conducted to compare the hearing results of patients with cartilage tympanoplasty with results in patients who underwent revision tympanoplasty using perichondrium. Both series of patients had undergone type I tympanoplasty, and the middle ear pathology was considered to be similar between the two groups. TM closure was achieved in all 22 patients undergoing cartilage reconstruction, but three of the 20 patients undergoing perichondrium reconstruction had a recurrent perforation during the follow-up period (approximately 1 year). The average pre- and postoperative pure-tone average air-bone gap (PTA-ABG) was 21.1 dB and 6.8 dB for the cartilage group and 17.9 dB and 7.7 dB for the perichondrium group, respectively. These gains in hearing were statistically significant (P < 0.001 in each case), but there was no statistically significant difference in hearing results between the two groups. Analysis of the PTA-ABG as a function of percentage of TM reconstructed showed no statistically significant difference in hearing results due to percentage of cartilage used. These results indicate that cartilage tympanoplasty offers the possibility of a rigorous TM reconstruction with excellent postoperative hearing results.

Adolescent↗

PubMed1998

Intact canal wall mastoidectomy with tympanoplasty for cholesteatoma in children.

OBJECTIVE/HYPOTHESIS: Cases of cholesteatoma in pediatric patients were reviewed to determine which factors influence the outcome of surgical treatment. Cholesteatoma is considered a more aggressive disease in children than in adults. The outcomes of intact canal wall (ICW) mastoidectomy and canal wall down (CWD) mastoidectomy were assessed, as comparisons of different surgical technique. STUDY DESIGN: A retrospective analysis of all cases of pediatric cholesteatoma treated at a single institution by the senior author (P.R.L.) over a period of 11 years was conducted. METHODS: Patient information was collected from an otology database, patient records, and audiology files. RESULTS: Sixty-six patients, aged 10 months to 18 years, were treated and followed for an average of 37.7 months (range 12.2 months to 12.5 y). ICW mastoidectomy with tympanoplasty was the primary surgical treatment in 41 patients. Nineteen percent had residual disease at a planned second stage surgery and 22% developed recurrent cholesteatoma for a total recidivism rate of 41%. A SRT of less than 30 dB HL was achieved in 75% of these patients. Seventeen patients underwent CWD mastoidectomy with tympanoplasty initially. Two patients (12%) had residual cholesteatoma found at a planned second state procedure, and no recurrent cholesteatoma was encountered. Seventy-two percent maintained a SRT of less than 30 dB HL. CONCLUSIONS: These results support the continued use of ICW mastoidectomy with tympanoplasty for pediatric cholesteatoma. If planned second stage surgery is necessary, the long-term results of an ear with useful hearing and few problems with chronic medical care are gratifying. For reasons of anatomy or in an only hearing ear, CWD mastoidectomy with tympanoplasty provides a safe ear and good hearing results. Mastoid cavity care must be maintained indefinitely in many cases.

Adolescent↗

PubMed2001

Recent outcome of tympanoplasty in the elderly.

OBJECTIVE: To investigate the outcome of tympanoplasty in the elderly (patients older than 60 years) compared with younger patients. PATIENTS AND STUDY DESIGN: Retrospective review of 87 (28.3%) older patients among a total of 307 patients with chronic otitis media with or without cholesteatoma who were surgically treated at a university hospital by the senior author. Follow-up was systematically provided at the same institution. INTERVENTIONS: Surgery included tympanoplasty with mastoidectomy performed as the primary procedure in 358 ears. Tympanoplasty was performed with canal-wall-up or canal-wall-down with canal wall reconstruction, ossiculoplasty with autologous or homologous ossicle interposition or columella. Mean follow-up was 30 months (range, 12-70 months). MAIN OUTCOME MEASURES: Pre- and postoperative air- and bone-conduction thresholds were calculated as an average of three speech frequencies (0.5, 1, and 2 kHz). Analysis was subsequently carried out on the postoperative air-bone gap, hearing gain, and postoperative problems such as elevation of the bone-conduction threshold, delayed epithelialization, and reperforation of the eardrum. Statistical analysis was performed by chi-square or Student's t-test. A p value less than 0.05 was considered significant. RESULTS: Compared with results from younger patients, there was no particular disadvantage in postoperative hearing results and complications in the elderly, although preoperative bone-conduction thresholds were gradually worsened with age. CONCLUSIONS: There is no contraindication for tympanoplasty in older patients if their physical status is the same or better than what is normal for their chronological age.

Adolescent↗

PubMed2001

Anterior subannular T-tube for prolonged middle ear ventilation during tympanoplasty: evaluation of efficacy and complications.

OBJECTIVE: We previously described the use of anterior subannular T-tubes (n = 20) for long-term middle ear ventilation. In the current study, we examine a larger patient population (n = 38) and a longer follow-up interval (average >2 years) to evaluate the efficacy and safety of anterior subannular tympanostomy. STUDY DESIGN: Retrospective nonrandomized case review. SETTING: Tertiary referral hospital. PATIENTS: Our series consisted of 38 consecutive patients with a diagnosis of eustachian tube dysfunction, adhesive otitis media, or chronic otitis media with a perforation who underwent a tympanoplasty. INTERVENTION: A subannular T-tube was placed anteriorly at the time of tympanoplasty to provide long-term middle ear ventilation. MAIN OUTCOME MEASURES: The main outcomes of this study are tube position, tube patency, and middle ear ventilation. In addition, hearing was evaluated both preoperatively and postoperatively and any complications were noted. RESULTS: There were 38 patients and 38 ears that received an anterior subannular T-tube at the time of tympanoplasty. The study group consisted of 24 female patients and 14 male patents with a median age of 36 years (range, 10-75 yr). All 38 patients had eustachian tube dysfunction, 22 had adhesive otitis media, 23 had chronic otitis media, 13 had a cholesteatoma, 11 had tympanic membrane perforations, and 3 patients had a cleft palate. All patients underwent tympanoplasty. Eighteen patients had a concomitant ossiculoplasty and 7 had a mastoidectomy. Follow-up ranged from 1 month to 48 months (average, 26 mo). Three tubes had extruded within 2 years, in 1 case resulting in a persistent perforation. Postoperative complications included 1 patient with a partially extruded prosthesis, 2 patients with tipped prosthesis and persistent tympanic membrane retraction, and 1 patient with a plugged tube. All other tubes were patent and showed no evidence of migration. Furthermore, there were no cases of anterior canal blunting or ingrowth of epithelium around the tube. CONCLUSION: Anterior subannular tympanostomy is a safe and effective method for long-term middle ear ventilation in patients with chronic eustachian tube dysfunction.

Adolescent↗

PubMed2003

Type III tympanoplasty applying the palisade cartilage technique: a study of 61 cases.

OBJECTIVE: To determine the morphologic and hearing results of the combined application of the palisade cartilage technique and titanium ossicular replacement prostheses in Type III tympanoplasty. STUDY DESIGN: Retrospective review of 61 tympanoplasties. SETTING: Tertiary referral center. PATIENTS: 59 patients (39 women and 20 men, mean age 36 years, range 7-81 years) consecutively operated on because of cholesteatoma, adhesive otitis, chronic otitis media, subtotal tympanic membrane defects, and tympanofibrosis requiring tympanoplasty with ossiculoplasty. INTERVENTIONS: Tympanoplasty Type III, with application of the palisade cartilage technique and total or partial titanium ossicular replacement prosthesis. MAIN OUTCOME MEASURES: Otoscopic findings and hearing results using a four-frequency pure tone average air-bone gap. RESULTS: A recurrent defect was seen in 1 ear (1.6%). The graft take rate was 100%. There were no extrusions of prostheses. Preoperatively, a pure tone average air-bone gap of 0 to 10 dB was seen in 1 ear, 11 to 30 dB in 30, and 31 to 50 dB in another 30 ears. Postoperatively, the corresponding numbers were 11, 41, and 9 ears, respectively. Hearing results were better in the total ossicular replacement prosthesis group. CONCLUSIONS: The palisade cartilage technique is suitable to manage difficult pathologic conditions in middle ear surgery. It was demonstrated that the palisade cartilage technique can be combined safely with titanium ossicular replacement prostheses. Regarding postoperative hearing results, the negative preselection of pathologic conditions must be considered.

Adolescent↗

PubMed2003

Cartilage palisades in type III tympanoplasty: anatomic and functional long-term results.

OBJECTIVE: To evaluate the long-term anatomic and functional results after partial and total autologous cartilage palisade type III tympanoplasties to assess the efficacy of cartilage palisades in preventing recurrent cholesteatoma. STUDY DESIGN: Retrospective data bank and patient review. SETTING: Tertiary referral center. PATIENTS: The study population included all patients with more than 36 months follow-up who underwent tympanoplasty or tympanomastoidectomy for previously untreated cholesteatoma using partial or total autologous cartilage palisade graft associated with a reconstruction of the ossicular chain from October 1, 1992, to October 31, 1998. INTERVENTION: Tympanoplasty or tympanomastoidectomy using autologous cartilage palisade graft for partial or total reconstruction of the tympanic membrane and the ossicular chain. MAIN OUTCOME MEASURES: Anatomic results, i.e., closure of the perforation, rate of retraction pockets, recurrent cholesteatoma, and reperforation rate related to the use of autologous cartilage were clinically evaluated. Postoperative speech reception thresholds, speech discrimination scores, and postoperative air-bone gap were compared with preoperative levels. The outcomes of canal wall up and canal wall down procedures were compared. RESULTS: Closure of the tympanic membrane was achieved in 98.3% of patients. Speech reception thresholds did not change significantly. Speech discrimination scores were stable or improved in all patients. Postoperative air-bone gap was less than 10 dB in 29.8% of patients and between 11 and 20 dB in 32.3%. The complication rate of the tympanoplasty in general was 0.67%. The rate of recurrences of cholesteatoma was 2.2%. No complications could be related to the use of cartilage. CONCLUSIONS: The cartilage palisade technique is effective for the reconstruction of the tympanic membrane and also prevents new retractions and recurrences of cholesteatoma. The functional results show that autologous cartilage grafts are able to transmit sound.

Audiometry, Pure-Tone↗

PubMed2003

Middle-ear mechanics of Type III tympanoplasty (stapes columella): I. Experimental studies.

OBJECTIVE: To investigate the mechanics of Type III tympanoplasty by developing a cadaveric temporal bone model. BACKGROUND: Type III stapes columella tympanoplasty involves the placement of a tympanic membrane graft, usually made of temporalis fascia, directly onto the stapes head. The procedure is usually done in conjunction with a canal wall down mastoidectomy. Postoperative hearing results vary widely, with air-bone gaps of 10 to 60 dB. The structural features responsible for the wide range in hearing results have not been systematically investigated. METHODS: Canal wall down Type III procedures were performed in eight cadaveric temporal bones. Acoustic stimuli were presented in the ear canal, and round window velocity VRW (used as an index of hearing) was measured, while systematically varying stapes mobility, mechanical properties of tympanic membrane graft, and tightness of connection between tympanic membrane graft and stapes. The effect of interposing a thin cartilage disc between the tympanic membrane graft and stapes head was also assessed. RESULTS: When the middle ear was aerated and the stapes was mobile, VRW was 15 to 30 dB lower than in an intact, normal ear. Stapes fixation led to a significant reduction in VRW; reduction was greatest at low frequencies. There was little effect of varying the tightness of connection between the tympanic membrane graft and stapes head. Sound energy was transmitted from the graft to the stapes as long as the graft was in physical contact with the stapes head. Different tympanic membrane graft materials with a range of mechanical properties (stiffness and mass) resulted in little variation in VRW. Interposing a thin cartilage disc between the tympanic membrane graft and stapes improved VRW in the lower frequencies by 5 to 10 dB. The authors hypothesize that the disc acted to increase the effective vibrating area of the graft. CONCLUSIONS: The feasibility of using a cadaveric temporal bone model to study the mechanics of Type III tympanoplasty was demonstrated. A mobile stapes and aerated middle ear were essential for a successful Type III tympanoplasty. There was little effect of varying the mechanical properties of the tympanic membrane graft or changing the tightness of connection between the graft and stapes head. Improved results were achieved by interposing a thin cartilage disc between the graft and stapes head to increase the effective vibrating area of the graft.

Aged↗

PubMed2005

Cartilage shield tympanoplasty: a reliable technique.

OBJECTIVE: Cartilage shield tympanoplasty is a procedure for repairing total tympanic membrane perforations. This procedure is indicated primarily for patients with total perforations, severely atelectatic tympanic membranes, and failures of previous tympanoplasty associated with chronic eustachian tube dysfunction. Although the graft take of this technique has been reported to be excellent, there have been concerns regarding hearing results because it replaces the entire tympanic membrane with cartilage. The purpose of this study was to report our experience with this technique. STUDY DESIGN: Retrospective chart review. SETTING: Tertiary care hospital: Virginia Commonwealth University Medical Center, Richmond, Virginia, USA. PATIENTS: Between 1998 and 2003, 62 patients were identified who had a cartilage shield tympanoplasty. The patients' ages ranged from 7 to 72 years (mean, 32 years). INTERVENTION: Therapeutic. MAIN OUTCOME MEASURES: Graft take was evaluated in all patients and postoperative complications were noted. In 58 patients, pre- and postoperative audiograms were available and pure-tone average air-bone gaps were compared using the Student's t test. RESULTS: Graft take was accomplished in 61 patients (98.4%) and there were no postoperative complications. The average preoperative and postoperative pure-tone average air-bone gap was 32.4 +/- 14.1 dB and 24 +/- 13.7 dB, respectively (p < 0.005). CONCLUSION: This study reveals that cartilage shield tympanoplasty has a high degree of graft take, and hearing results are satisfactory.

Adolescent↗

PubMed2000

Correlation of pure tone audiogram results and hearing benefit of tympanoplasty for chronic suppurative otitis media.

The aim of this study was to evaluate the correlation between pure tone audiogram results and the subjective sensation of hearing benefit of patients who had tympanoplasty for chronic suppurative otitis media. This is a prospective study of 115 patients who had tympanoplasty between 1992 and 1994. The outcome, including a pure tone audiogram and the subjective sensation of hearing benefit, was evaluated at 1 year after operation. There were 63 (55%) patients with subjective hearing benefit after the tympanoplasty. The subjective sensation of hearing benefit correlated with the magnitude of the air conduction (AC) threshold reduction, and increased from 39% for an AC reduction of less than or equal to 10 dB to 100% for an AC reduction of more than 30 dB. The effect of the interaural AC threshold difference on the subjective sensation of hearing was not significant; improvement was felt by 92% of patients when the operated ear became the better hearing ear, and by 73% of patients when the operated ear remained the worse hearing ear. There was considerable discrepancy between the subjective hearing benefit and the pure tone audiogram results. A combination of parameters, including the air-bone gap, the AC threshold, and the subjective hearing change, is recommended in reporting the results of tympanoplasty.

Audiometry, Pure-Tone↗

PubMedDate not supplied

Surgical treatment of chronic middle ear disease. 1. Myringoplasty and tympanoplasty.

Results of myringoplasty or tympanoplasty were evaluated in 225 ears followed for at least one year after surgery. Repair of the tympanic membrane with an underlay connective tissue graft (fascia in 90%) was successful in 97% of the ears. One late perforation developed 3 years postoperatively. The average postoperative air-bone gap was 4.8 dB in 88 cases of myringoplasty, the series including three ears with a rigid footplate. Rigid incus and malleus should not be mobilized but subjected to resection and reconstruction. Poor tubal function caused adhesive changes in one ear (1%). In tympanoplasty the average postoperative air-bone gap was 11.3 dB in 100 ears with stapes present and 20.6 dB in 36 ears with only the footplate remaining. Of the 137 tympanoplasty ears, 10 (7%) showed prominent adhesive changes. In 36 ears with cholesteatoma there was one recurrence 3 years later (3%). An air-bone gap of less than 20 dB was postoperatively noted in 94% of the ears undergoing myringoplasty and in 69% of the ears undergoing tympanoplasty.

Ear Diseases↗