[Efficacy of middle ear surgery for patients with hearing aids and middle ear disease]

Of 356 cases that underwent middle ear surgery for hearing improvement, 30 (8.4%) with air conduction hearing aids and middle ear disease were evaluated pre- and postoperatively. All surgeries were performed by the same surgeon. Diagnoses included 22 chronic otitis media, 5 chronic otitis media with cholesteatoma, 1 otosclerosis and 2 ossicular anomaly. Chief complaints at the first visit to Fukui Medical University Hospital were otorrhea (17 cases), hard of hearing (28 cases), dizziness (2 cases) and tinnitus (2 cases). Nineteen patients underwent surgery on both ears and eleven on one ear including five ears that showed better hearing preoperatively. Surgical procedures were tympanoplasty type I (15 cases), modified type III (8 cases), modified type IV (3 cases), stapedotomy (2 cases) and implantable hearing device (2 cases). After surgery, 16 patients (group 1) did not need hearing aids, while 14 (group 2) still needed hearing aids. Preoperative hearing was 64.1dB (n = 30) on average and average hearing one year after surgery in group 1 (35.4 +/- 14.1dB) was significantly better than in group 2 (58.1 +/- 18.4dB). After surgery, otorrhea stopped in all cases (100%), subjective hearing loss improved in 82% of the patients, vertigo improved in 100% and tinnitus improved in 50%. These results emphasize the benefits of surgical therapy, and the reasons why it should be recommended to patients with hearing aids and middle ear disease, such as to improve hearing disorders, to stop otorrhea and to prevent progressive sensorineural hearing loss.