Postoperative results of tympanoplasty with mastoidectomy in elderly patients with chronic otitis media.

OBJECTIVES

We evaluated the long-term results of tympanoplasty with mastoidectomy in elderly patients with chronic otitis media (COM).

METHODS

We included 192 patients with intractable COM who underwent both tympanoplasty and mastoidectomy from the same surgeon between January 2003 and December 2006 and were followed up for more than 3 years. The patients were divided into two groups: an "old COM group" of 83 patients (more than 65 years of age) and a "young COM group" of 109 patients (between 21 and 40 years of age). We compared the preoperative and postoperative levels of hearing, the types of tympanoplasty and mastoidectomy, and the postoperative complications of the two groups.

RESULTS

Among the old COM group, 11 patients (13.3%) showed temporary postoperative complaints without serious sequelae. Between the old and young COM groups, there were no significant differences in the rates of associated cholesteatoma, middle ear swab culture results, or type of tympanoplasty, ossiculoplasty, and mastoidectomy. In the comparison of postoperative hearing improvement, both the old and young COM groups showed a significant decrease in airbone gap, although the old COM group showed a significantly worse preoperative air-bone gap. There were no significant differences in the rates of re-perforation of the tympanic membrane or of reoperation between the two groups.

CONCLUSIONS

From this study, we conclude that there is no reason to withhold surgery for COM on the assumption that older patients do not have good results or that the procedure is too risky.