Factors Affecting Tinnitus Following Non-Type Ⅰ Tympanoplasty
ZHOU Yaguang
ZHAI Yuhong
GUO Li
CHEN Yanwen
CAO Xianbao
CHEN Xianquan
ZHENG Tiane
Abstract：Objective To report characteristics of tinnitus in patients with middle ear disease and conductive deafness after non-type Ⅰ tympanoplasty,and factors that may affect postoperative tinnitus as well as management strategies.Methods Data from patients with conduction deafness admitted to the Department of Otolaryngology,Head and Neck Surgery,920th Hospital of the Joint Logistics Support Force from May 2009 to March 2020 who were treated with type Ⅱ or Ⅲ tympanoplasty or Piston procedure under general anesthesia by the same surgeon were retrospectively analyzed,including the timing and incidence of tinnitus and the correlation between tinnitus and hearing recovery,as well as between postoperative tinnitus and use of manubrium of the malleus or long process of incus inⅡ tympanoplasty.Results Following standard type Ⅱ tympanoplasty and Piston procedure,tinnitus mostly occurred within 1 month and might improve along with hearing recovery.In non-standard type Ⅱ and type Ⅲ tympanoplasty,tinnitus mostly occurred within 3 months.Except for standard type Ⅱ tympanoplasty,tinnitus could occur in as late as one year.At 3 months,cases with tinnitus improvement showed better air conduction(AC)hearing and Air-bone-gap(ABG)improvement than those with persisting tinnitus(P＜0.05).Standard type Ⅱ tympanoplasty was associated with lower incidence of tinnitus and better improvement of air conduction hearing and ABG as compared to non-standard type Ⅱand type Ⅲ tympanoplasty(P＜0.05),but not Piston procedure(P＞0.05).Conclusion Our results emphasize the use of malleus manubrium and long process of incus in tympanoplasty.Avoiding direct coupling of PORP with the fascia via cartilage graft and preservation of ligaments and stapedius muscle may help achieve tympanic and ossicular chain compliance.The concept of coherent tympanoplasty is important and further research is needed for complications after TORP type Ⅲ tympanoplasty.
Keywords：postoperative tinnitusharmonic tympanoplastyrigid tympanoplasty
Publication Date：2024-10-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 740-743 )