Chonnam Med J CMJ Chonnam Medical Journal 0377-9564 Chonnam National University Medical School 10.4068/cmj.2009.45.2.122 Original Article Comparison of Hearing Results by Type of Tympanoplasty with Mastoid Obliteration during Chronic Otitis Media Surgery Choi Jeong Uk Oh Seung Eun Lee Dong Hoon Cho Yong Bum Cho Hyong Ho Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School, Gwangju, Korea. Corresponding author (victocho@hanmail.net) 08 2009 12 08 2009 45 2 122 126 08 07 2009 Copyright © 2009 Chonnam National University Medical School 2009

Mastoid obliteration during chronic otitis media (COM) surgery could improve hearing results by enhancing the acoustic properties of the external auditory canal. The objective of this study was to compare postoperative hearing results by type of tympanoplasty with mastoid obliteration during COM surgery. Twenty-five COM patients (25 ears) underwent tympanoplasty type III during canal wall down (CWD) mastoidectomy and mastoid obliteration: 10 patients underwent classic tympanoplasty type III (group I), and 15 patients underwent columellarization between the tympanic membrane and the stapes head with a partial ossicular replacement prosthesis or cartilage (group II). Hearing results and complications were compared between the 2 groups. Postoperative air-bone gap (ABG) levels within 20 dB were 30% and 60% in group I and group II, respectively. Closure of the ABG was significantly better in group II than in group I (p<0.05). No serious complications were observed in either group. In CWD tympanomastoidectomy with mastoid obliteration, tympanoplasty using strut results in greater hearing improvement than does classic tympanoplasty type III.

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Operation findings. (A) PORP insertion after canal wall down mastoidectomy. (B) The anterior based musculoperiosteal flap placed into the cavity above bone pate and cartilage obliteration. PORP; partial ossicular replacement prosthesis.

Schematic of type III tympanoplasty during mastoid obliteration. (A) classic tympanoplasty type III (group I). (B), (C) subtype tympanoplasty type III (group II). FN, facial nerve; PORP, partial ossicular replacement prosthesis; Sc-PORP, Columella over stapes head-partial ossicular replacement prosthesis; Sc-SC, Columella over stapes head-short columellization.

Mean preoperative and postoperative air-bone gap according to the type of tympanoplasty. (*p<0.05) ABG, air-bone gap; group I, classic tympanoplasty type III; group II, subtype tympanoplasty type III.

Mean preoperative and postoperative air-bone gap according to strut in Group II. (p>0.05) ABG, air-bone gap; PORP, partial ossicular replacement prosthesis.

Complications of canal wall down tympanoplasty and mastoidectomy with mastoid obliteration

All infected cases resolved with medical treatment; EAC; external auditory canal.