Masalha Muhamed, Shlizerman Lev, Mazzawi Salim, Handzel Ophir, Kassem Firas, Briscoe Daniel, Siag Kfir
Department of Otolaryngology Head and Neck Surgery, Emek Medical Center, Afula, Israel, Rappaport Faculty of Medicine, Technion-Institute of Technology, Haifa, Israel.
Department of Otolaryngology Head and Neck Surgery, Emek Medical Center, Afula, Israel.
Isr Med Assoc J. 2023 Jan;25(1):42-46.
Chronic suppurative otitis media is a long-standing middle ear infection with a perforated tympanic membrane. Tympanoplasty is the mainstay of treatment. Most surgeons prefer to operate on dry ears; however, this may be difficult to achieve.
To investigate the effect of otorrhea and positive cultures on the outcome of tympanoplasty.
This retrospective analysis reviewed patients with chronic suppurative otitis media who underwent tympanoplasty 2008-2015. Patients were divided into three groups: active discharge and bacterial growth, active discharge without bacterial growth, and no ear discharge. Surgical outcomes were compared among the groups.
Among 101 patients included, 43 ears (42.6%) had discharge preoperatively, 58 (57.4%) were dry. Overall closure rate was 81.2% (82/101). Preoperative active discharge closure rate was 88.3% (38/43) and without discharge 75.9% (44/58). There were 38 positive cultures preoperatively and five negative cultures. Cultures were not obtained in 58 cases. Success rates were 89.5%, 80%, and 75.9%, respectively. No significant difference was found between patients who had positive or negative cultures before the procedure (P > 0.48) or among the three groups (P = 0.25). The most common bacteria were Pseudomonas aeruginosa (n=17), followed by Staphylococcus species (n=10). None was significantly associated with operative failure (P = 0.557). The postoperative air threshold difference was not affected by culture results (P = 0.3).
Tympanoplasty success rates and postoperative air threshold differences were not affected by the presence of preoperative otorrhea or positive ear cultures. Surgery can be performed even when the ear is not dry.
慢性化脓性中耳炎是一种鼓膜穿孔的中耳长期感染疾病。鼓室成形术是主要的治疗方法。大多数外科医生倾向于在干耳状态下进行手术；然而，这可能难以实现。
研究耳漏和培养阳性对鼓室成形术结果的影响。
这项回顾性分析纳入了2008年至2015年接受鼓室成形术的慢性化脓性中耳炎患者。患者分为三组：有活动性耳漏且细菌生长、有活动性耳漏但无细菌生长、无耳漏。比较三组的手术结果。
在纳入的101例患者中，43耳（42.6%）术前有耳漏，58耳（57.4%）为干耳。总体闭合率为81.2%（82/101）。术前有活动性耳漏的闭合率为88.3%（38/43），无耳漏的为75.9%（44/58）。术前有38次培养阳性和5次培养阴性。58例未进行培养。成功率分别为89.5%、80%和75.9%。术前培养阳性或阴性的患者之间（P>0.48）或三组之间（P = 0.25）均未发现显著差异。最常见的细菌是铜绿假单胞菌（n = 17），其次是葡萄球菌属（n = 10）。均与手术失败无显著相关性（P = 0.557）。术后气导阈值差异不受培养结果影响（P = 0.3）。
鼓室成形术的成功率和术后气导阈值差异不受术前耳漏或耳培养阳性的影响。即使耳朵不干也可进行手术。
