An analysis of the single-stage tympanoplasty with over-underlay grafting in tympanosclerosis.
OBJECTIVE
Our objective was to analyze the results of tympanosclerosis surgery using over-underlay tympanoplasty and to find out the effect of single-stage surgery on hearing results.


METHODS
Forty-two patients who were operated on for tympanosclerosis between July 1998 and February 2002 were included in the study. These were one-stage tympanoplasties, because second-stage operations and revisions were not included. Operative records and audiograms of the patients were obtained. Of the patients, 48% had bilateral tympanosclerosis. In three (7.1%) of the patients, tympanosclerosis and cholesteatoma occurred concomitantly. The cog was present in eight (20%) of 40 mastoidectomies. Körner's septum was present in nine (22.5%) patients. The graft take rate was 95.2%.


RESULTS
The pre- and postoperative air-bone gap values of the patients were not significantly different (p > 0.05). Thirty-three percent of the patients met the successful hearing criteria (air-bone gap <20 dB). However, 47% had an air-bone gap closure between 20 dB and 30 dB, whereas 20% had a gap of more than 30 dB.


CONCLUSIONS
Single-stage surgery does not result in a satisfactory hearing improvement in most of the patients with tympanosclerosis. Only one third of the patients, most of whom had a mobile stapes, had satisfactory hearing results. Mobilization of a fixed stapes is not an effective option for hearing restoration in tympanosclerosis. Second-stage surgery for stapedectomy and placement of a prosthesis-like piston or total ossicular replacement prosthesis should be considered to obtain better hearing results in tympanosclerosis.
Bayazit
Yildirim A
YA
Department of Otolaryngology, Faculty of Medicine, Gazi University, Besevler, Ankara, Turkey. bayazity@yahoo.com
Ozer
Enver
E
Kara
Cengiz
C
Gökpinar
Serkan
S
Kanlikama
Muzaffer
M
Mumbuç
Semih
S
D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold; D018424:Cholesteatoma, Middle Ear / Q000150:complications; D004427:Ear Diseases / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007188:Incus / Q000601:surgery; D008297:Male; D008416:Mastoid / Q000601:surgery; D012189:Retrospective Studies; D012598:Sclerosis; D013200:Stapes Mobilization; D019737:Transplants; D016896:Treatment Outcome; D014432:Tympanic Membrane / Q000473:pathology* / Q000601:surgery / Q000637:transplantation*; D014433:Tympanoplasty / Q000379:methods*