[Observation of tympanosclerosis operation result]

To assess effects of multi-technique operation for tympanosclerosis.

A retrospective analysis of 157 cases (167 ears)of tympanosclerosis (the cases with only tympanic membrane calcification were excluded) was undertaken. All patients received the multi-technique if needed: (1) Open the attic, mastoid antrum etc; (2) Rebuild scute with auto-bone or infill the mastoid cavity with auto bone pieces; (3) Preserve or reconstruct the ossicular chain; (4) Utilize the absorbable Merogel to prevent re-adhering; (5) Press prostheses with tympanic chorda nerve as a spring; (6) Clear out hyperplastic bone on facial canal with Er-laser or small chisel. Postoperative audiometric measurements were undertaken within one month. And the follow up audiometric measurements were performed at three months after surgery, and then every half or one year later again. The last evaluations were considered as the results of follow up (taking the average hearing threshold at 0.5, 1.0, 2.0 kHz HL).

The mean air-bone gap (ABG) of 167 ears was (39.74 +/- 12.54) dB before operation, while it was elevated to (20.68 +/- 11.80)dB after operation (P < 0.01). Surgical treatment was found to be successful in seventy-one ears (42.5%) and effective in forty-eight ears (28.7%). The total effectiveness was 71.3% (119 ears). Followup result was (20.67 +/- 13.52) dB, compare with pre-operative hearing threshold (P < 0.01). However, it had no difference comparing with post-operative hearing threshold (P > 0.05). Of 96 ears which were followed up over 1 year, the average ABG was (21.94 +/- 11.16) dB comparing with that of the total 167 ears follow up result (P > 0.05).

Using multi-technique can obtain better and consistent hearing results. Surgery for total ossicular chain fixation of tympanosclerosis is still difficult. Stapedectomy still needs to apply in tympanosclerosis cautiously.