Preoperative Hearing Predicts Postoperative Hearing

Abstract

Optimal hearing is one goal of otologic surgery. It is generally presumed that hearing thresholds after tympanoplasty-mastoidectomy surgery are determined by remaining anatomy. We assessed the effect of the disease process on hearing after surgery, and our data do not support this presumption. We studied the relationship between preoperative and postoperative hearing across tympanoplasties with differing anatomies in 124 patients without ossicular reconstruction with prostheses or bone. Our results indicate that poor hearing before surgery is associated with poor hearing after surgery, regardless of anatomy (type of tympanoplasty). This relationship holds for both the airbone gap and the speech-reception threshold. When considering ossicular reconstruction, the surgeon should remember that the disease process itself affects hearing in addition to the physical attributes of the ear. These results should be considered in preoperative counseling, as well as in the interpretation of the otologic literature.

Audiologic Results of Surgery for Cholesteatoma

“…In this study, preoperative hearing loss was lower in tensa cholesteatoma, older patients, revision operations, bilateral process, and more intense ossicular damage. The potential for hearing gain is greatest for patients having larger preoperative ABGs (14). We confirmed worse results for the groups with worse preoperative hearing level, as in other studies.…”

A Comparison of Postoperative Hearing Gain in Dry and Wet Ear Tympanoplasty

“…8 Blakley et al found that in ears with persistent infection, the hearing outcome after tympanomastoidectomy surgery depended more on pre-operative hearing level than on the type of tympanoplasty performed. 9 Anita Krishnan et al observed postoperative air-bone gap of less than 20 dB is in 75% of cases with quiescent ear and 80% of cases with dry ears who underwent tympanomastoidectomy. 10 Eero Vartianen et al observed that the pre-operative ear status whether dry or wet did not significantly affect the improvement of mean air-bone gap.…”

Hearing evaluation after successful myringoplasty

“…Some reports state that the degree of hearing improvement depends upon many factors, such as the site and size of perforation, ossicular chain status, pneumatization of mastoid air cells, and surgeon experiences, in addition to the surgical technique applied, type of graft used, and functioning status of the Eustachian tube ( Black and Wormald, 1995 , Blakley et al., 1998 ).…”