Results of Healing and Auditory Gains in Tympa-noplasties

Overview

During the two-year-period (1998-1999) at the ENT department of the General FacultyHospital in Prague a total of 71 tympanoplastic operations were made in 64 patients, incl. 22 children aged 5-14 years. The number camprised 17 primary operations and 54 revisions on 64 ears.The authors evaluate the results of healing and auditory gains in groups TORP (38), PORP (8),interposition (16), manubriostapedopexy (5) and other reconstructions (4). Anatomical healing wasrecorded in 67 (94 %) ears. All ears where for reconstruction of the tympanic cavity a siliconemembrane was used healed. The functional results were evaluated in healed ears by comparing theaerial-bone difference before and after surgery and in particular according to the resultingpostoperative transmission loss of frequencies from 250 to 400 Hz. Significant improvement ofhearing (reduction or elimination of transmission loss) was recorded in almost 70% of all operatedears. Smaller losses than 10 dB were recorded in 60 % (3) ears) after manubriostapedopexy, 43% (3)ears with PORP, both ears after interposition of bone between the long arm of the incus and stapes,only 17 % (2) ears after interposition of the incus and 28% (10) ears with TORP. In TORP andinterposition of the incus the resulting transmission loss was most frequently between 11 and20 dB. The greatest auditory gains were achieved at frequencies 250, 500 and 1000 Hz in all types of reconstructions, in PORP also at frequency 4000 Hz. The highest gains were achieved afterinterporition, in PORP and manubriostapedopexy. Greater auditory gains are achieved where thesuprastructures of the stapes are preserved. Socially acceptable hearing on the operated ear wasrecorded in 56-75% patients in the different groups, less in the group of TORP, most in the groupPORP and interposition. The patient group is followed up and extended to make possible evaluationalso of long-term anatomical and functional results in different types of reconstruction.

Key words:
tympanoplasty, results of healing, auditory gains.