Shakti Apoorva, Vaidya Sudhakar, Agrawal Anjana, Satyarthy Vikram
Ruxmaniben Deepchand Gardi Medical College, Ujjain, India.
Indian J Otolaryngol Head Neck Surg. 2022 Aug;74(Suppl 1):74-78. doi: 10.1007/s12070-020-01832-x. Epub 2020 Mar 31.
This study mainly focus on hearing loss pattern in CSOM patients undergoing tympanoplasty surgery or tympanomastoidectomy pre-operatively and analysis of the outcome of the surgery in terms of improvement in hearing (air-bone gap) after 3 months of the surgery.
All patients of age 15-65 years reporting to ENT OPD with ear discharge and decreased hearing were screened with detailed history, clinical examination and microscopic examination.110 cases of tympanic membrane perforation who were fit for surgery were advised tympanoplasty or tympanoplasty with mastoidectomy.
Our study shows that postoperative air-bone gap closure is maximum for cortical mastoidectomy type I tympanoplasty (14.03 dB), followed with cortical mastoidectomy with type II (12.2 dB), Type I tympanoplasty (11 dB), cortical mastoidectomy with type III (7.72 dB). Procedures combined with modified radical mastoidectomy showed a very poor mean improvement in our study.
It is very difficult to predict the results preoperatively because outcome will depend on extent of involvement of middle ear cleft by the disease process which can only be assessed intraoperatively.
本研究主要关注接受鼓室成形术或鼓室乳突切除术的慢性化脓性中耳炎(CSOM)患者术前的听力损失模式,并分析术后3个月听力改善(气骨导差)方面的手术结果。
所有年龄在15 - 65岁、因耳漏和听力下降到耳鼻喉科门诊就诊的患者,均接受详细病史、临床检查和显微镜检查。110例适合手术的鼓膜穿孔患者被建议行鼓室成形术或鼓室成形术联合乳突切除术。
我们的研究表明,术后气骨导差闭合情况,I型鼓室成形术联合皮质乳突切除术最大(14.03dB),其次是II型皮质乳突切除术联合鼓室成形术(12.2dB)、I型鼓室成形术(11dB)、III型皮质乳突切除术联合鼓室成形术(7.72dB)。在我们的研究中,联合改良乳突根治术的手术平均改善效果很差。
术前很难预测结果,因为结果将取决于疾病过程中耳裂受累的程度,而这只能在术中评估。