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Correlation between middle-ear pressure-regulation functions and outcome of type-I tympanoplasty.
Auris Nasus Larynx. 2007 Jun; 34(2):173-6.AN

Abstract

OBJECTIVES

To examine the correlation between the middle-ear pressure-regulation functions including active eustachian tube (ET) functions and transmucosal gas exchange function, and outcome of tympanoplasty.

PATIENTS AND METHODS

Seventy five patients (78 ears) with non-cholesteatomatous chronic otitis media with eardrum perforation but without ossicular damage or middle-ear anomaly participated in this study. Before surgery, patency of the ET was examined by applying positive pressure to the middle ear through the eardrum perforation, and then the ET pressure-regulation functions were examined using the inflation-deflation test. Also their transmucosal gas exchange function was evaluated by examining the presence or absence of aeration in the mastoid on the CT before surgery or through the microscope during the surgery. All of them underwent type-I tympanoplasty, and their postoperative conditions including the hearing were followed for more than 6 months. The outcome of the surgery was judged as poor outcome when they had any of the following conditions; more than 20 dB of mean air-bone gap, spontaneous perforation within 6 months, or persistent wet condition including recurrent otorrhea.

RESULTS

First, the outcome of all the four ears of which ETs were considered mechanically obstructed was poor. Next, among the remaining 74 ears, none of the three individual parameters, including positive and negative middle-ear pressure-equalizing functions and mastoid aeration, showed significantly positive correlation with the outcome of the surgery, but significantly higher incidence of poor outcome was seen only when all the three parameters were poor.

CONCLUSIONS

These results indicated that impairment of all the middle-ear pressure-regulation functions was likely to cause poor outcome of tympanoplasty, and also allowed us reconfirm that ears with mechanically obstructed ETs were contraindicated for tympanoplasty. Therefore, assessment of mastoid condition is important as well as the ET function before tympanoplasty.

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Authors+Show Affiliations

Takahashi H
Department of Otolaryngology, Head and Neck Surgery, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki 852-8501, Japan. htak0831@net.nagasaki-u.ac.jp
Sato H
No affiliation info available
Nakamura H
No affiliation info available
Naito Y
No affiliation info available
Umeki H
No affiliation info available

MeSH

AdolescentAdultAgedAir PressureChildChronic DiseaseEar, MiddleEustachian TubeFemaleFollow-Up StudiesHumansMaleMastoidMiddle AgedOtitis MediaPostoperative ComplicationsPrognosisRecurrenceTympanic Membrane PerforationTympanoplasty

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17055205

Citation

Takahashi, Haruo, et al. "Correlation Between Middle-ear Pressure-regulation Functions and Outcome of type-I Tympanoplasty." Auris, Nasus, Larynx, vol. 34, no. 2, 2007, pp. 173-6.
Takahashi H, Sato H, Nakamura H, et al. Correlation between middle-ear pressure-regulation functions and outcome of type-I tympanoplasty. Auris Nasus Larynx. 2007;34(2):173-6.
Takahashi, H., Sato, H., Nakamura, H., Naito, Y., & Umeki, H. (2007). Correlation between middle-ear pressure-regulation functions and outcome of type-I tympanoplasty. Auris, Nasus, Larynx, 34(2), 173-6.
Takahashi H, et al. Correlation Between Middle-ear Pressure-regulation Functions and Outcome of type-I Tympanoplasty. Auris Nasus Larynx. 2007;34(2):173-6. PubMed PMID: 17055205.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Correlation between middle-ear pressure-regulation functions and outcome of type-I tympanoplasty. AU - Takahashi,Haruo, AU - Sato,Hiroaki, AU - Nakamura,Hajime, AU - Naito,Yasushi, AU - Umeki,Hiroshi, Y1 - 2006/10/19/ PY - 2006/07/13/received PY - 2006/09/21/revised PY - 2006/09/21/accepted PY - 2006/10/24/pubmed PY - 2007/8/10/medline PY - 2006/10/24/entrez SP - 173 EP - 6 JF - Auris, nasus, larynx JO - Auris Nasus Larynx VL - 34 IS - 2 N2 - OBJECTIVES: To examine the correlation between the middle-ear pressure-regulation functions including active eustachian tube (ET) functions and transmucosal gas exchange function, and outcome of tympanoplasty. PATIENTS AND METHODS: Seventy five patients (78 ears) with non-cholesteatomatous chronic otitis media with eardrum perforation but without ossicular damage or middle-ear anomaly participated in this study. Before surgery, patency of the ET was examined by applying positive pressure to the middle ear through the eardrum perforation, and then the ET pressure-regulation functions were examined using the inflation-deflation test. Also their transmucosal gas exchange function was evaluated by examining the presence or absence of aeration in the mastoid on the CT before surgery or through the microscope during the surgery. All of them underwent type-I tympanoplasty, and their postoperative conditions including the hearing were followed for more than 6 months. The outcome of the surgery was judged as poor outcome when they had any of the following conditions; more than 20 dB of mean air-bone gap, spontaneous perforation within 6 months, or persistent wet condition including recurrent otorrhea. RESULTS: First, the outcome of all the four ears of which ETs were considered mechanically obstructed was poor. Next, among the remaining 74 ears, none of the three individual parameters, including positive and negative middle-ear pressure-equalizing functions and mastoid aeration, showed significantly positive correlation with the outcome of the surgery, but significantly higher incidence of poor outcome was seen only when all the three parameters were poor. CONCLUSIONS: These results indicated that impairment of all the middle-ear pressure-regulation functions was likely to cause poor outcome of tympanoplasty, and also allowed us reconfirm that ears with mechanically obstructed ETs were contraindicated for tympanoplasty. Therefore, assessment of mastoid condition is important as well as the ET function before tympanoplasty. SN - 0385-8146 UR - https://www.unboundmedicine.com/medline/citation/17055205/Correlation_between_middle_ear_pressure_regulation_functions_and_outcome_of_type_I_tympanoplasty_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0385-8146(06)00138-6 DB - PRIME DP - Unbound Medicine ER -