Long-term outcomes after tympanoplasty with and without mastoidectomy for perforated chronic otitis media

Abstract

The objectives of the retrospective study, performed at a tertiary referral center, were to examine the prognostic factors predicting long-term outcomes of tympanoplasty for perforated chronic otitis media (COM) and to determine whether mastoidectomy can be avoided during tympanoplasty for perforated COM. Between 1987 and 2002, 213 patients with perforated COM underwent tympanoplasty by the same surgeon and were followed for more than 5 years. Postoperative hearing outcomes were considered successful, if the postoperative air-bone gap was within 20 dB. Closure of perforation by a single surgery was considered a successful graft. Long-term outcomes were analyzed using logistic regression analysis. Normal ossicular chain was the only factor that showed a significantly favorable relation to long-term hearing outcomes. There were no significant predictors of long-term successful graft outcomes. Mastoidectomy was not a significant factor predicting long-term outcomes. Our long-term outcomes showed that mastoidectomy can be an avoidable surgical procedure in tympanoplasty for perforated COM, even if the ear is infected.

Impact of odor exposure time on olfactory parameters

“…[22] Tos recommended mastoidectomy for discharging ears, and Mishiro et al reported that they do not routinely perform mastoidectomy for simple tympanic membrane perforations accompanied by chronic otitis media. [23] In the present study, the rate of graft success after tympanoplasty was significantly higher in patients with epitympanic patency (p<0.001). In addition, the presence of …”

Long-Term Outcomes after Performing Tympanoplasty without Mastoidectomy for Active and Inactive Noncholesteatomatous Chronic Otitis Media

“…Both the canal wall up and the canal wall down technique can be applied with acceptable audiometric results [6]. Although the mastoid and tympanic antrum seem to be filled with lesions as shown by high-resolution computerized tomography (HRCT) and magnetic resonance (MR) imaging, the available literature supports the notion that therapeutic mastoidectomy does not have any additional benefits for the management of noncholesteatomatous COM [3,[7][8][9][10]. However, we are not sure if it has the same long-term outcomes without performing mastoidectomy for noncholesteatomatous COM in variable preoperative infections.…”

“…Mastoidectomy does not produce any additional benefits for the patients. Mishiro et al [10] performed tympanoplasty in 213 patients with tympanic membrane perforations caused by chronic suppurative otitis media and followed them for more than 5 years. Logistic regression analysis showed that the ossicular chain was the only factor for evaluating long-term hearing outcomes after surgery, and even in active infection conditions, mastoidectomy was unnecessary.…”

Tympanoplasty type 1 in the treatment of patients with sclerotic mastoid: anatomical and functional results

“…They also reported that tympanoplasty without mastoidectomy could be performed under local anesthesia which might be preferred especially in the elderly and patients with medical complications. [15] In this study also the risks caused by mastoidectomy were reported. As far as we know, sensorineural hearing loss may occur because of drill trauma, secondary meningitis may develop because of dura mater trauma at tegmen tympani zone, massive bleeding may be served due to sigmoid sinus trauma and facial nerve injury may occur during mastoidectomy.…”