Learning Objectives:
Background: 30% of all patients treated in our ENT-department are patients with the pathology of middle ear. Out of all our patients with chronic otitis media 54% have cholesteatoma. Hearing function recovering is considered as impotent as complete cholesteatoma removing.
In some cases of cholesteatoma it was observed that after surgery there is an improvement not only of sound conduction but also of sound perception.
Objective: The investigation of possible reasons of sound perception improvement of patients after removing cholesteatoma with tympanoplasty.
Materials and methods: An assessment of 256 patients hearing results was carried out retrospectively. The patients underwent surgery on account of chronic otitis media with cholesteatoma from 2009 to 2015. Hearing assessment was analyzed by data mean value for 4 frequencies: 500 ;Hz, 1000 ;Hz, 2000 ;Hz, 4000 ;Hz before surgery and 3 and 6 months after surgery. Moreover, air-bone interval, air-conductive thresholds and bone-conductive thresholds were assessed before and after surgery, and the absolute increase of air conduction was measured after surgery.
Carefully recoded surgery protocols were analyzed.
Results and discussion: According to the analysis of data it was found that an improvement of hearing thresholds mean value occurs not only for air conduction but also for bone conduction in 32 % of the cases. All patients were divided in 2 groups: with increasing bone conduction and without increasing bone conduction. Several points in these groups were analyzed.
According to the analysis of surgeries' protocols, in 87% of cases there was sound perception improvement of those patients who had cholesteatoma localized in the round window area and had it completely removed during surgery.
Conclusions: Removing cholesteatoma from the round window region promotes sound perception improvement due to the free movement of the round window membrane that, in its turn, improves the movement of perilymph.
