Clinical Characteristics of Chronic Perforated Otitis Media in Different Age Groups
Masayo Hasegawa1, Akihiro Shinnabe, Hiromi Kanazawa
1Department of Otorhinolaryngology, Jichi Medical University Saitama Medical Center, Saitama, Japan. m.hasegawa0428@jichi.ac.jp.
Insights
Elderly patients with chronic perforated otitis media show less mastoid pneumatization and poorer hearing outcomes, suggesting more severe childhood ear conditions. This impacts tympanoplasty success rates.
Area of Science:
- Otolaryngology
- Audiology
- Medical Imaging
Background:
- Chronic perforated otitis media (CPOM) is a common condition affecting middle ear health.
- Age-related differences in the clinical presentation and surgical outcomes of CPOM are not fully understood.
- Understanding these variations is crucial for tailoring treatment strategies.
Purpose of the Study:
- To analyze preoperative and intraoperative clinical characteristics of CPOM across different age groups.
- To compare tympanoplasty techniques, mastoid pneumatization, preoperative hearing, and patch effects among younger, middle-aged, and elderly patients.
Main Methods:
- Retrospective analysis of 137 tympanoplasties in 133 patients with CPOM.
- Exclusion of patients with ear adhesions, cholesteatoma, or prior tympanoplasty.
- Categorization into younger (15-39), middle (40-64), and elderly (≥65) groups.
- Comparison of Wullstein classification, mastoid air-cell area (CT scan), preoperative aeration, hearing levels, and patch effect.
Main Results:
- Type I tympanoplasty was less frequent in the elderly group (p<0.05).
- Elderly patients had significantly lower mastoid pneumatization indices (p<0.05).
- Significant differences in preoperative air- and bone-conduction hearing were observed across age groups (p<0.05).
- No significant differences in air-bone gap were found.
- The younger group showed a significantly better patch effect (p<0.05).
Conclusions:
- Elderly patients with CPOM exhibit reduced mastoid pneumatization and ossicular pathology.
- These findings suggest a history of more prolonged and severe childhood middle ear disease in older individuals.
- Age-specific factors influence surgical outcomes in tympanoplasty for CPOM.
Objective:
We aimed to analyze preoperative and intraoperative clinical characteristics of chronic perforated otitis media by patient age.
Materials And Methods:
We analyzed 137 tympanoplasties for chronic perforated otitis media in 133 patients. Exclusion criteria were ear adhesions, cholesteatoma, and a history of tympanoplasty. Patients were divided into a younger group (aged 15-39 years), a middle group (40-64 years), and an elderly group (≥65 years). We compared tympanoplasty technique (using Wullstein classification), mastoid air-cell area measured by temporal bone computed tomography, preoperative aeration of the temporal bone, mean preoperative hearing (at 500 Hz, 1000 Hz, and 2000 Hz), and patch effect calculated by the pre- and post-patch air-bone gap at frequencies of 250 Hz and 500 Hz among the three age groups.
Results:
Although type I tympanoplasty was performed most frequently in all age groups, it was performed significantly less often in the elderly group (p<0.05). The mean mastoid pneumatization index was significantly lower in the elderly group (p<0.05). Preoperative air-conduction hearing and bone-conduction hearing differed significantly among age groups (p<0.05 for both). There were no significant differences in the air-bone gap among the three groups. The mean patch effect was significantly better in the younger group than in middle or elderly groups (p<0.05).
Conclusion:
The less pneumatized mastoid and ossicular diseases in elderly patients with chronic perforated otitis media suggest that they had longer lasting and more severe childhood middle ear pathologies than did younger patients.
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