Chonnam Med J.  2009 Aug;45(2):122-126. 10.4068/cmj.2009.45.2.122.

Comparison of Hearing Results by Type of Tympanoplasty with Mastoid Obliteration during Chronic Otitis Media Surgery

• Choi JU
• Oh SE
• Lee DH
• Cho YB
• Cho HH

• KMID: 2172272
• DOI: http://doi.org/10.4068/cmj.2009.45.2.122

Abstract

Mastoid obliteration during chronic otitis media (COM) surgery could improve hearing results by enhancing the acoustic properties of the external auditory canal. The objective of this study was to compare postoperative hearing results by type of tympanoplasty with mastoid obliteration during COM surgery. Twenty-five COM patients (25 ears) underwent tympanoplasty type III during canal wall down (CWD) mastoidectomy and mastoid obliteration: 10 patients underwent classic tympanoplasty type III (group I), and 15 patients underwent columellarization between the tympanic membrane and the stapes head with a partial ossicular replacement prosthesis or cartilage (group II). Hearing results and complications were compared between the 2 groups. Postoperative air-bone gap (ABG) levels within 20 dB were 30% and 60% in group I and group II, respectively. Closure of the ABG was significantly better in group II than in group I (p<0.05). No serious complications were observed in either group. In CWD tympanomastoidectomy with mastoid obliteration, tympanoplasty using strut results in greater hearing improvement than does classic tympanoplasty type III.

Keyword

Otitis media; Obliteration; Tympanoplasty

MeSH Terms

Acoustics
Cartilage
Ear Canal
Head
Hearing
Humans
Mastoid
Ossicular Prosthesis
Otitis
Otitis Media
Stapes
Tympanic Membrane
Tympanoplasty

Figure

• 

  Fig. 1 Operation findings. (A) PORP insertion after canal wall down mastoidectomy. (B) The anterior based musculoperiosteal flap placed into the cavity above bone pate and cartilage obliteration. PORP; partial ossicular replacement prosthesis.

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  Fig. 2 Schematic of type III tympanoplasty during mastoid obliteration. (A) classic tympanoplasty type III (group I). (B), (C) subtype tympanoplasty type III (group II). FN, facial nerve; PORP, partial ossicular replacement prosthesis; Sc-PORP, Columella over stapes head-partial ossicular replacement prosthesis; Sc-SC, Columella over stapes head-short columellization.

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  Fig. 3 Mean preoperative and postoperative air-bone gap according to the type of tympanoplasty. (*p<0.05) ABG, air-bone gap; group I, classic tympanoplasty type III; group II, subtype tympanoplasty type III.

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  Fig. 4 Mean preoperative and postoperative air-bone gap according to strut in Group II. (p>0.05) ABG, air-bone gap; PORP, partial ossicular replacement prosthesis.

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