Korean J Otorhinolaryngol-Head Neck Surg.  2017 Dec;60(12):626-632. 10.3342/kjorl-hns.2017.00871.

The Effect of Mastoidectomy Combined with Tympanoplasty Type I on Postoperative Hearing in Chronic Otitis Media Patients Older than 65 Years

• Sung CM
• Kim HY
• Park JM
• Lee S
• Cho HH
• Cho YB

• KMID: 2401402
• DOI: http://doi.org/10.3342/kjorl-hns.2017.00871

Abstract

BACKGROUND AND OBJECTIVES
Although canal wall up mastoidectomy (CWUM) has been performed frequently as a treatment for chronic otitis media (COM), the necessity of CWUM for non-cholesteatomatous COM (NCCOM) is still controversial. Since elderly people often have systemic problems, there is a high likelihood of side effects after general anesthesia, so it is important to judge the necessity of mastoidectomy. The purpose of this study was to investigate the effect of CWUM for the treatment of NCCOM in patients over 65 years of age.
SUBJECTS AND METHOD
Forty-two cases of CWUM with tympanoplasty type I performed as a treatment for NCCOM from 2007 through 2016 were reviewed retrospectively. Pure tone audiometry was performed preoperatively and postoperatively, and preoperative temporal bone CT was used to evaluate the mastoid status. The valsalva maneuver (VM) was used to evaluate the eustachian tube function.
RESULTS
The total number of patients was 42 and the success rate of eardrum repair was 92.8%. Comparison of hearing results taken preoperatively and postoperatively showed significant hearing improvement in both air conduction and air-bone gap. When hearing results were compared according to the mastoid status and the response of VM, there were no significant differences.
CONCLUSION
Mastoidectomy combined with tympanoplasty type I showed a high success rate of ear drum repair and good hearing improvement, with no critical side effects. Therefore, mastoidectomy does not need to be limited by one's old age. Adequate mastoidectomy after proper consideration of the mastoid status will be helpful in the treatment of the disease.

Keyword

Chronic otitis media; Elderly; Hearing; Mastoidectomy; Type I tympanoplasty

MeSH Terms

Aged
Anesthesia, General
Audiometry
Ear
Eustachian Tube
Hearing*
Humans
Mastoid
Methods
Otitis Media*
Otitis*
Retrospective Studies
Temporal Bone
Tympanic Membrane
Tympanoplasty*
Valsalva Maneuver