Type II tympanoplasty in chronic cholesteatoma and granulomatous otitis media - distant results of otosurgery. 2014

Maciej Wiatr, and Jacek Składzień, and Jerzy Tomik, and Paweł Stręk, and Anna Przeklasa-Muszyńska
Department of Otolaryngology, Head and Neck Surgery, Jagiellonian University, Cracow, Poland. Electronic address: mwiatr@mp.pl.

OBJECTIVE The objective of this study is to evaluate the impact of changes to the mucous in the middle ear on the outcome of the reconstruction of the ossicular chain exemplified by a type 2 tympanoplasty. METHODS A prospective analysis was carried out with regard to patients operated on at the Otolaryngology Department at Collegium Medicum, Jagiellonian University, between 2007 and 2011 due to conditions of the middle ear. The patients who had undergone surgical treatment for the first time because of chronic otitis media were taken into account. The operations involving a type 2 tympanoplasty were earmarked for further analysis. The effectiveness of treatment was measured by the change of the Air-Bone Gap (AGP). RESULTS The analysis covered 47 patients, whose own modeled incuses were placed on normal stapes. The patients were divided into two groups (with and without cholesteatoma). A statistically significant hearing improvement was observed in the patients with cholesteatoma. In the group without cholesteatoma and with a prevalence of granulomatous lesions, no statistically significant hearing improvement was observed 6 and 12 months following the ear surgery. CONCLUSIONS In the patients with cholesteatoma and a minor damage to the ossicular chain, a significant hearing improvement is observed after ossiculoplasty. An occurrence of granulomatous lesions is an unfavorable predictor. The Air-Bone Gap measured before the surgery often does not the actual advancement of the pathological process, and hearing improvement after the surgery cannot be prognosticated on the basis of that amount alone.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010033 Otitis Media Inflammation of the MIDDLE EAR including the AUDITORY OSSICLES and the EUSTACHIAN TUBE. Middle Ear Inflammation,Inflammation, Middle Ear
D011379 Prognosis A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations. Prognostic Factor,Prognostic Factors,Factor, Prognostic,Factors, Prognostic,Prognoses
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002781 Cholesteatoma A non-neoplastic mass of keratin-producing squamous EPITHELIUM, frequently occurring in the MENINGES; bones of the skull, and most commonly in the MIDDLE EAR and MASTOID region. Cholesteatoma can be congenital or acquired. Cholesteatoma is not a tumor nor is it associated with high CHOLESTEROL. Cholesteatomas
D002908 Chronic Disease Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care (Dictionary of Health Services Management, 2d ed). For epidemiological studies chronic disease often includes HEART DISEASES; STROKE; CANCER; and diabetes (DIABETES MELLITUS, TYPE 2). Chronic Condition,Chronic Illness,Chronically Ill,Chronic Conditions,Chronic Diseases,Chronic Illnesses,Condition, Chronic,Disease, Chronic,Illness, Chronic
D005260 Female Females
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup

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