Centro Hospitalar Universitário do Porto, Department of Otolaryngology and Head and Neck Surgery, Porto, Portugal.
Centro Hospitalar Universitário do Porto, Department of Otolaryngology and Head and Neck Surgery, Porto, Portugal.
Am J Otolaryngol. 2023 Jan-Feb;44(1):103680. doi: 10.1016/j.amjoto.2022.103680. Epub 2022 Oct 20.
There are several factors that seem to affect the surgical success rate of tympanoplasty, one of them being the pneumatization of the contralateral mastoid. In the current literature, several studies have been published with classification proposals for temporal bone pneumatization pattern. This study aims to evaluate the role of mastoid air cell extension in relation to the sigmoid sinus in predicting the surgical success of tympanoplasty.
This case-control study was performed on patients diagnosed with chronic otitis media (COM) who underwent type I tympanoplasty. The study group did not close the tympanic membrane, or there was a retraction or lateralization of the graft. The control group consisted of patients with surgical success.
No statistically significant difference was found between groups regrading age, gender, perforation side/type, previous nasal surgery, and the presence of chronic otitis media in contralateral ear. A statistically significant difference was found when groups were compared in relation to the degree of pneumatization of the contralateral ear (p = 0.046), and this relationship does not seem to be influenced by age.
To predict surgical success in terms of tympanic membrane closure in tympanoplasty, classification of contralateral ear pneumatization degree using the sigmoid sinus as a reference seems to be a valid and easy to apply method, and makes it possible to restrict the evaluation of pneumatization to the mastoid, a cell complex that does not seem to change with age.
有几个因素似乎会影响鼓室成形术的手术成功率，其中之一是对侧乳突气房的气化。在当前的文献中，已经发表了几项关于颞骨气化模式分类建议的研究。本研究旨在评估乙状窦在预测鼓室成形术手术成功率方面与乳突气房延伸的关系。
本病例对照研究纳入了诊断为慢性中耳炎（COM）并接受 I 型鼓室成形术的患者。研究组鼓膜未闭合，或移植物回缩或移位。对照组为手术成功的患者。
在年龄、性别、穿孔侧/类型、既往鼻手术以及对侧耳慢性中耳炎方面，两组间无统计学差异。当比较两组时，发现对侧耳气房气化程度有统计学差异（p=0.046），并且这种关系似乎不受年龄的影响。
为了预测鼓室成形术鼓膜闭合的手术成功率，使用乙状窦作为参考对侧耳气房气化程度进行分类似乎是一种有效且易于应用的方法，并且可以将气房气化的评估限制在乳突，这是一个似乎不会随年龄变化的复杂气房。
