FP02-9. COMPARISON OF HEARING GAIN ACCORDING TO THE TYPE OF OSSICULOPLASTY AFTER CANAL WALL DOWN MASTOIDECTOMY
See-Ok Shin, Young-Seok Choi, Je-Yeob Yeon, Woo-Jin Jung (Chungbuk National University Hospital, Korea)
BACKGROUND and OBJECTIVES: Hearing improvement after tympanomastoidectomy is another major goal of surgery after eradication of disease, especially in cases with intact stapes. In situations with intact stapes during canal wall down (CWD) mastoidectomy, three types of ossiculoplasty are available; 1) classical tympanoplasty type III (Wullstein classification), 2) short columellization (SC) tympanoplasty using autologous material (ossicles or cartilage), 3) partial ossicular replacement prosthesis (PORP) tympanoplasty. The objective of this study is to compare the postoperative results of hearing gain and middle ear condition according to the types of ossiculoplasty described above.
MATERIALS and METHOD: Among the patients who had been found to have intact stapes during CWD mastoidectomy, 90 cases who have been followed up for more than 1 year after surgery, were selected. Classical tympanoplasty type III was performed in 30 cases, SC tympanoplasty in 38 cases, and PORP tympanoplasty in 22 cases. Age and sex distribution, success rate of hearing improvement, mean of postoperative air-bone gap (ABG), rate of middle ear adhesion were analysed according to the type of surgery.
RESULTS: 3 month after surgery, Success rates of hearing improvement were 37.4%, 51.4%, 57.4% in classical tympanoplasty type III, SC tympanoplasty, PORP tympanoplasty, respectively. Means of postoperative ABG were 25.1dB, 19.4dB, 17.2dB in classical tympanoplasty type III, SC tympanoplasty, PORP tympanoplasty, respectively. Hearing results were a statistically better in PORP tympanoplasty compared with other groups.
1 year after surgery, Success rates of hearing improvement were 21.1%, 35.5%, 58.8% in classical tympanoplasty type III, SC tympanoplasty, PORP tympanoplasty, respectively. Means of postoperative ABG were 29.1dB, 20.3dB, 16.7dB in classical tympanoplasty type III, SC tympanoplasty, PORP tympanoplasty, respectively .Hearing results were a statistically better in PORP tympanoplasty compared with other groupsRates of middle ear adhesion were 25%, 5.9% in classical tympanoplasty type III, tympanoplasty using strut, respectively.
CONCLUSION: In cases with intact stapes during CWD tympanoplasty, ossiculoplasty using strut is more useful for hearing improvement and prevention of middle ear adhesion than classical tympanoplasty type III, and PORP is more effective strut than autologous materials.
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