Hearing outcome after tympanoplasty type III

Area of Science:

• Otolaryngology
• Surgical Outcomes
• Audiology

Background:

• Chronic ear infections can lead to cholesteatoma or other inflammatory conditions.
• Tympanoplasty type III is a surgical procedure to address these middle ear issues.
• Assessing hearing outcomes is crucial for evaluating surgical success.

Purpose of the Study:

• To evaluate hearing outcomes following tympanoplasty type III.
• To compare outcomes in ears with cholesteatoma versus those without.
• To analyze the impact of different reconstruction methods and smoking on hearing.

Main Methods:

• 303 surgeries were analyzed, divided into cholesteatoma (CH) and chronic otitis media (COM_T_AP) groups.
• Air-bone gaps (PTA-ABG) were measured preoperatively and at early/late postoperative stages.
• Hearing results were compared across reconstruction types, smoking status, and correlated with staging indices (MER-I, OOPS-I).

Main Results:

• Tympanoplasty type III maintained hearing in the CH group and significantly improved it in the COM_T_AP group.
• All ossicular reconstruction types (PORP, TORP, cartilage) showed similar postoperative PTA-ABG around 20 dB.
• Smokers in the COM_T_AP group had higher initial air-bone gaps, which normalized later; no correlation found between hearing outcome and staging indices.

Conclusions:

• Tympanoplasty type III is effective for hearing preservation in cholesteatoma and improvement in chronic otitis media.
• Various ossicular replacement prostheses yield comparable hearing results.
• Smoking delays but does not permanently impair hearing recovery after tympanoplasty type III.