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[Tympanoplasty without mastoidectomy for active otitis media].

J Huang¹, L Yang², J Y Wang³

¹Department of Otolaryngology, Ningbo Donghai Hospital, Ningbo, 315040, China.

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi = Journal of Clinical Otorhinolaryngology Head and Neck Surgery

|May 26, 2018

Summary

Tympanoplasty without mastoidectomy is a viable treatment for chronic otitis media, regardless of middle ear infection status. This procedure shows comparable success rates in preventing relapse and improving hearing in both infected and uninfected ears.

Keywords:

otitis media,suppurative tympanoplasty wet ear

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Area of Science:

Otolaryngology
Surgical Innovation
Middle Ear Disease Management

Background:

Chronic otitis media (COM) presents challenges in treatment, particularly regarding surgical approaches.
The role of mastoidectomy in conjunction with tympanoplasty for COM is debated, especially in cases with suspected or confirmed mastoid involvement.

Purpose of the Study:

To evaluate the efficacy of tympanoplasty without mastoidectomy in treating chronic otitis media.
To compare surgical outcomes in patients with chronic otitis media based on the preoperative infective state of the middle ear.

Main Methods:

A cohort of 113 patients with COM underwent tympanoplasty without mastoidectomy.
Preoperative CT scans identified inflammatory lesions; patients were categorized into infected (72 ears) and uninfected (41 ears) groups.
Outcomes including dry ear canal rates, relapse, and hearing improvement (air-bone gap ≤ 20 dB) were assessed over a 1-year follow-up.

Main Results:

High rates of dry ear canals were observed post-surgery (95.8% in infected, 97.6% in uninfected groups).
Hearing improvement was achieved in 51.4% of infected and 48.8% of uninfected ears.
No cases of facial paralysis, dizziness, tympanic membrane invagination, or cholesteatoma were reported.

Conclusions:

Tympanoplasty without mastoidectomy is a feasible surgical option for chronic active otitis media, even with evidence of mastoid inflammatory lesions.
The preoperative infective status of the middle ear did not significantly impact postoperative relapse rates or hearing outcomes.