Canal wall down tympanoplasty surgery with or without ossiculoplasty in cholesteatoma: hearing results.
Aim of the study was to evaluate the functional results, in two homogeneous groups, for severity of the disease, submitted to canal-wall-down tympanoplasty (TPL CWD), with and without ossiculoplasty. A total of 60 patients who underwent canal-wall-down tympanoplasty for cholesteatoma were evaluated: 31 underwent ossiculoplasty (group A) and 29 classic Wullstein type III and IV operation (group B). Hearing results were evaluated 2 years after surgery according to the AAO-HHS guidelines. Pre-operative audiometrics revealed an air conduction PTA (AC-PTA) of 45.12 dB in group A, and 56.25 dB in group B. Bone conduction PTA (BC-PTA) was 16.86 dB in group A and 26.06 in group B. Two years after surgery, AC-PTA was 42.98 dB in group A and 58.65 dB in group B; BCPTA was 18.79 dB in group A and 25.13 dB in group B. The mean pre-operative ABG was 28.44 dB in group A and 30.14 dB in group B. Two years after surgery, group A showed a mean ABG of 24.06 and group B of 35.54 dB, the difference between the two groups was significant (p = 0.03). In conclusion, the functional results observed in the present study support the need to reconstruct the ossicular chain in canal-wall-down tympanoplasty, in fact, ossiculoplasty is associated with a better hearing gain than the classic Wullstein operations.
Institute of Otorhinolaryngology, "A. Gemelli" Polyclinic, Catholic University "Sacro Cuore", Rome, Italy.
A
A
Artuso
W
W
di Nardo
E
E
De Corso
M R
MR
Marchese
N
N
Quaranta
D000328:Adult; D001301:Audiometry, Pure-Tone; D018424:Cholesteatoma, Middle Ear / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D002908:Chronic Disease; D004424:Ear Canal / Q000601:surgery*; D005260:Female; D006314:Hearing Loss, Conductive / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008297:Male; D019933:Ossicular Replacement / Q000379:methods*; D010033:Otitis Media / Q000150:complications / Q000601:surgery; D012720:Severity of Illness Index; D014433:Tympanoplasty / Q000379:methods*