Results of middle ear reconstruction: do patients and surgeons agree?

The usual methods of measuring the therapeutic effects of middle ear reconstruction in tympanoplasty and stapedectomy take into account only changes occurring in the operated ear. These do not necessarily reflect the final state of the patient's auditory capacity, because normal speech perception is a bilateral function. Minor temporary interaural differences due, for example, to ear canal occlusion by cerumen can cause considerable distress. To determine what might be the final audiometric situations that would be worthwhile for patients having unilateral operations aimed only at improving auditory status, 203 patients' personal assessments of their final hearing ability were correlated with the audiometric data from both ears. The results indicated that the most relevant factor in predicting assessment was the postoperative hearing level.