Surgical treatment of tympanosclerosis.
OBJECTIVE
To report the hearing results of the surgical treatment of tympanosclerosis.


METHODS
A retrospective review of surgically treated cases of tympanosclerosis.


METHODS
A tertiary referral center.


METHODS
One hundred fifteen patients with middle ear tympanosclerosis operated on between 1987 and 1996, with an average age of 36 years (range 18-59 years). Cases were classified into four groups according to Wielinga and Kerr. Those with an associated cholesteatoma were excluded.


METHODS
Depending on the ossicular status, either mobilization of the major ossicles or epitympanic bypass procedure, mobilization of the stapes or stapedectomy.


METHODS
The postoperative pure-tone average was compared with the preoperative levels by use of conventional audiometry. The air-bone gap was measured.


RESULTS
The average postoperative air-bone gap was 18.0+/-10.21 dB in the type II group (attic fixation of the malleus-incus complex with a mobile stapes). 21.8+/-9.5 dB in the type III group (mobile malleus-incus complex, if present, with stapes footplate fixation), and 22.92+/-10.03 dB in the type IV group (fixation of both the stapes footplate and the malleus-incus complex). Patients with a fixed malleus and mobile stapes had significantly better hearing results than those with stapes fixation (p = 0.042, Mann-Whitney U test).


CONCLUSIONS
In ossicular attic fixation, atticotomy and mobilization of ossicles yielded better results than did the epitympanic bypass procedure. The difference, however, did not reach statistical significance. Patients with fixed stapes treated with stapedectomy displayed good hearing results immediately after surgery, but the air-bone gap deteriorated after some time.
Albu
S
S
Ear, Nose and Throat Department, Ospedale Civile Venezia, Venice, Italy.
Babighian
G
G
Trabalzini
F
F
D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009998:Ossicular Prosthesis; D012189:Retrospective Studies; D012598:Sclerosis / Q000473:pathology / Q000601:surgery; D013201:Stapes Surgery / Q000379:methods; D014432:Tympanic Membrane / Q000473:pathology* / Q000601:surgery*