The preoperative state of infection in chronic otitis media correlated with postoperative hearing results

Zusammenfassung

Unter besonderer Berücksichtigung des Schleimhautzustandes bei der Operation wurden die postoperativen Hörergebnisse bei 627 Ohren in einem Zeitraum von 5 bis 14 Jahren jährlich kontrolliert. Durchgeführt war eine Radikaloperation mit Obliteration der Höhle nach der Technik von Palva, ein Trommelfellersatz mit Temporalfaszie sowie ein Aufbau der Ossicula in bekannter Weise. Der postoperative Hörgewinn war besser, wenn die Schleimhaut im Mittelohr erhalten werden konnte. Dies war auch der Fall, wenn die Ohren bei der Operation trocken waren.

Summary

The postoperative long-term hearing results, with special reference to the state and management of the tympanic mucosa at operation, in 627 ears (574 patients) after an annual clinical follow-up period of 5–14 years are presented. The ears were operated on radically due to chronic otitis media, using the obliterative radical operation technique developed by T. Palva. The air-bone gap improved from the preoperative level significantly more in ears where the tympanic mucosa had been preserved than in ears where it had been removed at operation (p < 0.001). The improvement was also significantly better in dry ears than in ears which were moist or discharging at operation (p < 0.05). The mean late deterioration in the air-bone gap after the first follow-up year was significant in all the groups of ears (p < 0.05), and the mean long-term change in air-bone gap from pre- to late postoperative examination was the improvement of 3.0 dB in ears with, and a deterioration of 2.0 dB in ears without ossicular reconstruction.