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Type IV tympanoplasty revisited
1The Ipswich Hospital, Department of Ear, Nose and Throat, Suffolk, United Kingdom.
Objective:
There has been a great improvement in the material and design of prosthesis used for total ossicular reconstruction in recent years. As a result, the indication for type IV tympanoplasty has become more restricted. The long-term follow-up of type IV tympanoplasties performed by the author is presented.
Study Design And Setting:
This is a retrospective study of 31 patients who had type IV tympanoplasties performed by the author at the ear, nose, and throat clinic of a district general hospital.
Patients:
All the patients had chronic active otitis media with total loss of ossicles that were unsuitable for ossicular reconstruction.
Intervention And Main Outcome Measures:
The preoperative and postoperative air and bone conduction thresholds of all the patients who underwent type IV tympanoplasty were measured.
Results:
Twenty-six percent of the patients had a postoperative hearing level <40 dB and 58% had an air-bone gap <30 dB. The indication for type IV tympanoplasty can be categorized into four groups: severe atelectasis, patients with cleft palate, erosion of the footplate, and surgery on the better-only hearing ear.
Conclusion:
There still is a place for type IV tympanoplasty in modern otology.