Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-18T13:51:27.962Z Has data issue: false hasContentIssue false
  • English
  • Français

Factors affecting hearing improvement following successful repair of the tympanic membrane

Published online by Cambridge University Press:  25 February 2013

G Thiel ,
RP Mills  and
N Mills
G Thiel*
Affiliation:
Otolaryngology Unit, University of Edinburgh, Scotland, UK
RP Mills
Affiliation:
Otolaryngology Unit, University of Edinburgh, Scotland, UK
N Mills
Affiliation:
Department of Otolaryngology, Khon-Kaen Hospital, Khon Kaen, Thailand
*
Address for correspondence: Dr G Thiel, Otolaryngology Unit, Lauriston Building, Lauriston Place, Edinburgh EH3 9EN, Scotland, UK Fax: 0131 536 3744 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

The main aim of tympanic membrane repair is the elimination of chronic or intermittent aural discharge. Hearing improvement may or may not occur following a technically successful operation.

Method:

This study entailed a retrospective analysis of prospectively collected data from 203 operations that resulted in an intact tympanic membrane 6 months after surgery.

Results:

Complete hearing data were available for 169 operations on 160 patients. Of these, 53 per cent resulted in closure of the air–bone gap to within 10 dB, and 54 per cent of cases had post-operative hearing thresholds of at least 30 dB. The mean hearing change after surgery was +8.3 dB. Multiple regression analysis indicated that hearing improvement was more likely in large compared with small perforations. Smaller hearing gains occurred in ears with erosion of the stapes arch and/or fixation of the stapes, as well as in those with active discharge at the time of surgery and in revision cases.

Conclusion:

Greater hearing improvement can be expected following successful repair of perforations involving more than 50 per cent of the drum area. Poorer results are likely to occur in ears with additional middle-ear pathology and in revision cases.

Keywords

MyringoplastyOtitis MediaPrognosisTreatment Outcome
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 4 , April 2013 , pp. 349 - 353
Copyright
Copyright © JLO (1984) Limited 2013

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Giesen, M, Khan, N, Korinth, B. Early and late functional hearing results from a modified technique for tympanoplasty [in German]. HNO 1978;26:155–8Google ScholarPubMed
2Gyo, K, Yanagihara, N, Saiki, T, Hinohira, Y. Chronic otitis media and tympanoplasty in aged patients. Auris Nasus Larynx 1990;17:141–8CrossRefGoogle ScholarPubMed
3Bhat, NA, De, R. Retrospective analysis of surgical outcome, symptom changes, and hearing improvement following myringoplasty. J Otolaryngol 2000;29:229–32Google ScholarPubMed
4Sakagami, M, Mishiro, Y, Tsuzuki, K, Seo, T, Sone, M. Bilateral same day surgery for bilateral perforated chronic otitis media. Auris Nasus Larynx 2000;27:35–8CrossRefGoogle ScholarPubMed
5Mak, D, MacKendrick, A, Bulsara, M, Coates, H, Lannigan, F, Lehmann, D et al. Outcomes of myringoplasty in Australian Aboriginal children and factors associated with success: a prospective case series. Clin Otolaryngol Allied Sci 2004;29:606–11CrossRefGoogle ScholarPubMed
6Shrestha, S, Sinha, BK. Hearing results after myringoplasty. Kathmandu Univ Med J (KUMJ) 2006;4:455–9Google ScholarPubMed
7Karela, M, Sandeep, B, Watkins, B, Phillips, JJ. Myringoplasty: surgical outcomes and hearing improvement: is it worth performing to improve hearing? Eur Arch Otorhinolaryngol 2008;15:429–32Google Scholar
8Homøe, P, Nikoghosyan, G, Siim, C, Bretlau, P. Hearing outcomes after mobile ear surgery for chronic otitis media in Greenland. Int J Circumpolar Health 2008;67:452–60CrossRefGoogle ScholarPubMed
9Ribeiro, JC, Rui, C, Natercia, S, Jose, R, Antonio, P. Tympanoplasty in children: a review of 91 cases. Auris Nasus Larynx 2011;38:21–5CrossRefGoogle ScholarPubMed
10Westerberg, J, Harder, H, Magnuson, B, Westerberg, L, Hyden, H. Ten-year myringoplasty series: does the cause of perforation affect the success rate? J Laryngol Otol 2011;125:126–32CrossRefGoogle ScholarPubMed
11Robinson, K, Gatehouse, S, Browning, GG. Measuring patient benefit from otorhinolaryngological surgery and therapy. Ann Otol Rhinol Laryngol 1996;105:415–22CrossRefGoogle ScholarPubMed
12Donaldson, I, Snow, DG. A five year follow up of incus transposition in relation to the first stage tympanoplasty technique. J Laryngol Otol 1992;106:607–9CrossRefGoogle Scholar
13Sharp, JF, Terzis, TF, Robinson, J. Myringoplasty for the anterior perforation: experience with the Kerr flap. J Laryngol Otol 1992;106:14–16CrossRefGoogle ScholarPubMed
14Mehta, RP, Rosowski, JJ, Voss, SE, O'Neil, E, Merchant, SN. Determinants of hearing loss in perforations of the tympanic membrane. Otol Neurotol 2006;27:136–43CrossRefGoogle ScholarPubMed
15Wang, C, Zhao, S, Dai, H, Xia, Y, Zheng, J, Zhao, Y et al. Hearing results and an analysis of related impact factors following myringoplasty. J Clin Otorhinolaryngol Head Neck Surg 2008;22:577–9Google Scholar
16Bhat, KV, Naseeruddin, K, Nagalotimath, US, Kumar, PR, Hegde, JS. Cortical mastoidectomy in quiescent, tubotympanic, chronic otitis media: is it routinely necessary? J Laryngol Otol 2009;123:383–90CrossRefGoogle ScholarPubMed
17Ebenezer, J, Rupa, V. Preoperative predictors of incudal necrosis in chronic suppurative otitis media. Otolaryngol Head Neck Surg 2010;142:415–20CrossRefGoogle ScholarPubMed
18Shen, Y, Teh, BM, Friedland, PL, Eikelboom, RH, Atlas, MD. To pack or not to pack? A contemporary review of middle ear packing agents. Laryngoscope 2011;121:1040–8CrossRefGoogle ScholarPubMed
19Elmorsy, SM, Amer, HE. Insertion of middle-ear Silastic sheeting during tympanoplasty: hearing outcomes. J Laryngol Otol 2011;125:445–8CrossRefGoogle ScholarPubMed
20Ramakrishnan, A, Panda, NK, Mohindra, S, Munjal, S. Cortical mastoidectomy in surgery of tubotympanic disease. Are we overdoing it? Surgeon 2011;9:22–6CrossRefGoogle Scholar
21Lee, P, Kelly, G, Mills, RP. Myringoplasty: does the size of the perforation matter? Clin Otolaryngol 2002;27:331–4CrossRefGoogle ScholarPubMed
22de Zinis, LO, Cottelli, M, Koka, M. Inner ear function following underlay myringoplasty. Audiol Neurootol 2010;15:149–54CrossRefGoogle ScholarPubMed