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Bone conduction impairment in chronic ear disease
C J Linstrom1, C A Silverman, A Rosen
1Department of Otolaryngology-Head and Neck Surgery, Department of Veterans Affairs Medical Center, East Orange, New Jersey, USA.
The Annals of Otology, Rhinology, and Laryngology
|May 25, 2001
Summary
Ossicular reconstruction in chronic ear disease significantly improves bone conduction thresholds, particularly at 2,000 Hz. This suggests reconstruction restores the middle ear's contribution to bone conduction hearing.
Area of Science:
- Otolaryngology
- Audiology
- Surgical Otology
Background:
- Chronic ear disease, including cholesteatoma and otitis media, can elevate bone conduction (BC) thresholds.
- The middle ear's contribution to BC hearing, involving ossicular inertia and resonance, may be compromised by disease.
Purpose of the Study:
- To prospectively investigate the effect of ossicular reconstruction on BC thresholds in patients with chronic ear disease.
- To determine if surgical restoration of ossicles improves BC hearing compared to preoperative levels.
Main Methods:
- Prospective study of 24 patients with chronic ear disease undergoing tympanoplasty with mastoidectomy.
- Patients were divided into groups with (n=14) and without (n=10) ossicular reconstruction.
- Preoperative and postoperative BC thresholds were compared using paired-samples t-tests.
Main Results:
- Significant improvement in postoperative BC thresholds at 250, 1,000, and 2,000 Hz in the ossicular reconstruction group.
- Largest mean BC threshold improvement observed at 2,000 Hz post-reconstruction.
- No significant BC threshold improvement in the group without ossicular reconstruction; 71% showed improvement of at least 10 dB at two frequencies post-reconstruction.
Conclusions:
- Ossicular reconstruction effectively improves BC thresholds in chronic ear disease.
- The findings support the theory that middle ear ossicular function contributes to BC hearing, and reconstruction restores this contribution.
- Surgical intervention is crucial for enhancing BC hearing in affected patients.