The impact of Obstructive Middle Ear Inflammation on Tympanoplasty

YANG Donghui; LIANG Minzhi; TAN Xianggao

doi:10.3969/j.issn.1672-2922.2016.06.014

Abstract：objective To investigate the impact of obstructive middle ear inflammation on tympanoplasty, to facilitate selection of surgical treatment approaches. Methods Forty seven cases of chronic suppurative otitis media were divided in-to two groups the surgical approach to obstructive otitis media, i.e. intact canal wall mastoidectomy with tympanoplasty and surgical removal of obstructive inflammatory tissue from the tympanic cavity, tympanic antrum and mastoid (Group A, n=22), or tympanotomy plus tympanoplasty, with surgical removal of obstructive inflammatory tissue from the tympanum but not antrum and mastoid (Group B, n=25). The pre-and postoperative average air-bone gap and the rate of dry ear between the two groups were compared. Results After the operation, reduction of average air-bone was 16.50 ± 5.38 dB (P <0.05) and rate of dry ear was 95.5%(21/22) in group A, and 15.09±7.21 dB (P<0.05) and 92.0%(23/25), respectively, in group B. There were no statistically significant differences between the two groups (P>0.05). Conclusion The focus of surgical management should be inflammatory lesions around the ossicular chain in the meso-and epitympanic spaces. Removal of in-flammatory tissues in the tympanic antrum and mastoid does not seem to be critical nor does it affect postoperative dry ear and hearing. Minimally invasive surgical approach may be appropriate for management of chronic suppurative otitis media.