Middle ear ventilation function in patients with myringoplasty alone and myringoplasty plus mastoidectomy

In this study we investigated the correlation between middle ear pressure changes in patients with myringoplasty alone and together with intact canal wall mastoidectomy.

The tympanometric values of 102 patients with myringoplasty alone and 78 patients with myringoplasty plus intact canal wall mastoidectomy were examined by tympanometric analysis in this retro-prospective study. The study population consisted of 130 male and 50 female patients (mean age 25.3±7.7). All patients underwent myringoplasty with or without mastoidectomy due to chronic otitis without cholesteatoma. Patients with a value of less than -100 daPa during the postoperative follow-up were considered having normal middle ear ventilation. Independent-samples t-test was used for comparison of the analyses results of groups.

Sixty patients with myringoplasty (58.8%) and 55 patients with intact canal wall mastoidectomy (70.5%) had middle ear pressures less than -100 daPa at three months after surgery. The percentage of recovery over the first three years was 70.5% and 76.9% in the myringoplasty and intact canal wall mastoidectomy groups, respectively. The rate of persistent negative pressure is 21.6% and 14.1% in the myringoplasty and intact canal wall mastoidectomy groups, respectively. The number of patients who had negative middle ear pressure in myringoplasty group was higher than the number of those in intact canal wall mastoidectomy group at all intervals. However, when the rate of normalization over time was compared between two groups, no significant difference was found (p>0.05).

In first three months, the significantly higher number of patients achieving normal middle ear ventilation in mastoidectomy group compared to the patients without mastoidectomy is a finding which supports the additional effect of mastoidectomy on the pressure normalization function. However, the rate of normalization over time is not different between two groups. Middle ear pressure normalization is a continuous dynamic process and improvements may be seen for up to one year.