Usefulness of Strut in Ossiculoplasty during Canal Wall Down Tympanomastoidectomy

Shin, See Ok; Jung, Woo Jin; Choi, Young Suk; Lee, Dong Wook; Sim, Kyu Hwa; Yoo, Seung Du

Abstract

BACKGROUND AND OBJECTIVES: Hearing improvement after CWD tympanomastoidectomy is another major goal of surgery after eradication of disease, especially in cases with intact stapes. The objective of this study is to compare the postoperative results of hearing gain and middle ear condition according to the types of ossiculoplasty described above.
SUBJECTS AND METHOD
Of patients who received CWD tympanomatoidectomy, 90 who had been followed up for more than 1 year after surgery were selected. We found 30 cases of classical tympanoplasty type III, 38 SC tympanoplasty cases, and 22 PORP tympanoplasty cases. Age and sex distribution, success rate of hearing improvement, mean of postoperative air-bone gap (ABG), rate of middle ear adhesion were analysed according to the type of surgery.
RESULTS
At 3 months after surgery, success rates of hearing improvement were 37.0%, 51.4%, 57.1% for classical tympanoplasty type III, SC tympanoplasty, PORP tympanoplasty, respectively. Means of postoperative ABG in the above listed order were 25.1 dB, 19.4dB, 17.2 dB, respectively. Hearing results were statistically better in PORP tympanoplasty when compared with other groups (ANOVA with Duncan's multiple range test). At 1 year after surgery, success rates of hearing improvement were 21.1%, 35.5%, 64.7% in classical tympanoplasty type III, SC tympanoplasty, PORP tympanoplasty, respectively. Means of postoperative ABG in the above listed order were 29.1 dB, 20.3 dB, 16.7 dB, respectively. Hearing results were statistically better in PORP tympanoplasty compared with other groups (ANOVA with Duncan's multiple range test.). Rates of middle ear adhesion were 23.1%, 54.5% in classical tympanoplasty type III, tympanoplasty using strut, respectively.
CONCLUSION
In cases with intact stapes in CWD tympanoplasty, we conclude that tympanoplasty using strut is more useful for hearing improvement and prevention of middle ear adhesion than classical tympanoplasty type III; for the strut material, we found PORP more effective than autologous materials.