Recent outcome of tympanoplasty in the elderly

To investigate the outcome of tympanoplasty in the elderly (patients older than 60 years) compared with younger patients.

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.

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).

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.

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.

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.