title: Role of preoperative air-bone gap in tinnitus outcome after tympanoplasty for chronic otitis media with tinnitus.
abstract: BACKGROUND
  Previous reports indicated that middle ear surgery might partially improve tinnitus after surgery. However, until now, no influencing factor has been determined for tinnitus outcome after middle ear surgery.
  
  
  OBJECTIVE
  The purpose of this study was to investigate the association between preoperative air-bone gap and tinnitus outcome after tympanoplasty type I.
  
  
  METHODS
  Seventy-five patients with tinnitus who had more than 6 months of symptoms of chronic otitis media on the ipsilateral side that were refractory to medical treatment were included in this study. All patients were evaluated through otoendoscopy, pure tone/speech audiometer, questionnaire survey using the visual analog scale and the tinnitus handicap inventory for tinnitus symptoms before and 6 months after tympanoplasty. The influence of preoperative bone conduction, preoperative air-bone-gap, and postoperative air-bone-gap on tinnitus outcome after the operation was investigated.
  
  
  CONCLUSIONS
  The patients were divided into two groups based on preoperative bone conduction of less than 25dB (n=50) or more than 25dB (n=25). The postoperative improvement of tinnitus in both groups showed statistical significance. Patients whose preoperative air-bone-gap was less than 15dB showed no improvement in postoperative tinnitus using the visual analog scale (p=0.889) and the tinnitus handicap inventory (p=0.802). However, patients whose preoperative air-bone-gap was more than 15dB showed statistically significant improvement in postoperative tinnitus using the visual analog scale (p<0.01) and the tinnitus handicap inventory (p=0.016). Postoperative change in tinnitus showed significance compared with preoperative tinnitus using visual analog scale (p=0.006). However, the correlation between reduction in the visual analog scale score and air-bone-gap (p=0.202) or between reduction in tinnitus handicap inventory score and air-bone-gap (p=0.290) was not significant. We suggest that the preoperative air-bone-gap can be a predictor of tinnitus outcome after tympanoplasty in chronic otitis media with tinnitus.
authors.affiliation: Chonnam National University Medical School, Department of Otolaryngology, Gwangju, South Korea.
authors.forename: Hong Chan
authors.initials: HC
authors.lastname: Kim
authors.affiliation: Chonnam National University Medical School, Department of Otolaryngology, Gwangju, South Korea. Electronic address: chulsavio@hanmail.net.
authors.forename: Chul Ho
authors.initials: CH
authors.lastname: Jang
authors.affiliation: Chonnam National University Medical School, Department of Otolaryngology, Gwangju, South Korea.
authors.forename: Young Yoon
authors.initials: YY
authors.lastname: Kim
authors.affiliation: Chonnam National University Medical School, Department of Otolaryngology, Gwangju, South Korea.
authors.forename: Jong Yuap
authors.initials: JY
authors.lastname: Seong
authors.affiliation: Chonnam National University Medical School, Department of Otolaryngology, Gwangju, South Korea.
authors.forename: Sung Hoon
authors.initials: SH
authors.lastname: Kang
authors.affiliation: Chonnam National University Medical School, Department of Otolaryngology, Gwangju, South Korea.
authors.forename: Yong Beom
authors.initials: YB
authors.lastname: Cho
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001301:Audiometry, Pure-Tone; D002648:Child; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010033:Otitis Media / Q000601:surgery*; D057234:Preoperative Period; D012189:Retrospective Studies; D014012:Tinnitus / Q000209:etiology / Q000534:rehabilitation*; D016896:Treatment Outcome; D014433:Tympanoplasty; D055815:Young Adult
keywords: Gap aéreo-ósseo pré-operatório; Preoperative air-bone gap; Timpanoplastia tipo I; Tinnitus; Tympanoplasty type I; Zumbido