Middle ear surgery in Thuringia, Germany: a population-based regional study on epidemiology and outcome.
OBJECTIVE
To evaluate population-based data on incidence and efficiency of middle ear surgery.


METHODS
Retrospective review.


METHODS
All otolaryngology departments in one federal state in Germany.


METHODS
All 1,037 middle ear surgeries performed in Thuringia in 2005.


METHODS
Middle ear surgery.


METHODS
Analysis of preoperative and postoperative audiometric results, preoperative diagnostics, and postoperative complications. Univariate statistical tests were used to analyze predictors for air-bone gap (ABG) improvement, complications, and need for resurgery. Population data were used to calculate incidences of middle ear diseases admitted for surgery and annual rates of middle ear surgeries.


RESULTS
ABG improved after surgery for chronic otitis media without and with cholesteatoma, otosclerosis, trauma cases, or complication after acute otitis media/externa (p < 0.0001; p < 0.0001; p < 0.0001; p = 0.005; p = 0.004; respectively). Middle ear surgery significantly improved bone conduction in cases of otosclerosis (p = 0.008), sudden deafness (p = 0.006), and acute otitis media/externa with complication (p = 0.004). There was a trend of more complication in patients older than 60 years (p = 0.055). Surgery was indicated for chronic otitis media without cholesteatoma in 17.4/100,000 persons, for cholesteatoma in 15.0/100,000, for otosclerosis in 5.7/100,000, for sudden deafness with suspicion of perilymph fistula in 1.5/100,000, and for trauma with affection of the lateral cranial base and hearing loss or otitis media with complication in 1.3/100,000 habitants, respectively. A cochlear implant was indicated in 1.0/100,000 habitants.


CONCLUSIONS
This population based analysis is showing that middle ear surgery is performed country-wide with good results and low risk on important scale in daily routine by ear surgeons.
Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany.
Thomas
T
Fiedler
Daniel
D
Boeger
Jens
J
Buentzel
Dirk
D
Esser
Kerstin
K
Hoffmann
Peter
P
Jecker
Andreas
A
Mueller
Gerald
G
Radtke
Dietmar
D
Häfke
Thomas
T
Bitter
Orlando
O
Guntinas-Lichius
D000328:Adult; D000368:Aged; D001844:Bone Conduction / Q000502:physiology; D018424:Cholesteatoma, Middle Ear / Q000453:epidemiology* / Q000601:surgery; D004432:Ear, Middle / Q000601:surgery*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010033:Otitis Media / Q000453:epidemiology* / Q000601:surgery; D013506:Otologic Surgical Procedures / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome; D014433:Tympanoplasty / Q000379:methods