Long Term Final Outcome of Type III Tympanoplasty Procedures in Terms of Auditory Gain: A Cross Sectional Study (original) (raw)

Abstract

Background: In Cholesteatoma of the ear the ossicles are damaged to a great extent, sometimes leaving only the footplate of stapes. Type III Tympanoplasty only remains the choice of method for restoring the hearing mechanism. The present study aims to assess the final longterm hearing gain in different aged patients undergoing Type III Tympanoplasty procedure. Aims and objectives of the study: To assess and analyze the final long term hearing outcomes in patients undergoing canal wall down mastoidectomy with Type III Tympanoplasty procedure using stapes columella graft; to determine the graft success rate, and recurrence of Cholesteatoma. Materials: This study examined patients undergoing Type III Tympanoplasty with stapes columella grafting in 62 patients undergoing canal wall down Mastoidectomy for Cholesteatoma. Demographic data, Clinical findings of retraction pockets in tympanic membrane, X- Ray, CT scan findings, ossicular damage; type of ossicular prosthesis used were analyzed. Auditory assessment before and after surgery in terms of Air, Bone conduction values, PTA, air bone gap was taken as success criteria. Hearing acuity was assessed at 03 monthly intervals to observe the auditory gain in terms of air-bone closure and PTA. Results: 62 patients with CSOM with CH, satisfying the inclusion criteria were included. Males were 69.35% and females were 30.64%. The male: female ratio was 2.26:1. Patients were aged 20 to 50 years with mean age of 29.65±8.08 years. The mean values of PTA were 22.14± 4.23 in 31 (50%) patients, 30.20± 2.15 in 29 (46.77%) patients and 33.18± 3.10 in 02 (03.22%) patients at the end of 12 months; the air, bone conduction, air bone gap, PTA values were statistical significance, as the p- value was <0.05. Conclusion: Type III Tympanoplasty procedure is an ideal method of eradicating CH and restoring hearing to optimal levels. The status of ossicles following erosion by the disease determines the method of reconstruction and auditory gain. The type of ossicular prosthesis used has no significant role in achieving auditory gain. The present study has presented small data but it reflected the literature reviews of the benefit of Type III Tympanoplasty in CH management with low recurrence rates and long-term auditory gains for the patients. A larger surgical series would confirm further the benefits of such procedure.

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