2021 Volume 114 Issue 9 Pages 647-651
We investigated the hearing improvement rate and perforation closure rate after tympanoplasty for chronic otitis media (OMC) at our department. We recruited 194 cases of OMC who had undergone tympanoplasty at our hospital between April 2006 and March 2018. We evaluated the postoperative hearing improvement rate based on the Guideline for Reporting Hearing Results in Middle Ear and Mastoid Surgery (2010), and also the perforation closure rate. The overall hearing improvement rate was 88.1%. The hearing improvement rates in type I, type III and type IV tympanoplasty were 92.3%, 76.5%, and 25.0%, respectively. From 2006 to 2011, we performed atticotomy in combination with type I tympanoplasty in the 17.1% of patients with limited ossicle movement, and the hearing improvement rate was 80.0%. From 2012 onwards, 100% of patients with limited ossicle movement underwent atticotomy in combination with type I tympanoplasty, and the hearing improvement rate improved to 92.9%. The overall perforation closure rate was 89.2%. The perforation closure rate was 89.8% in Grade 1 cases, 88.8% in Grade 2 cases, 88.2% in Grade 3 cases, and 90.9% in Grade 4 cases. There was no difference in the perforation closure rate depending on the size of the perforation. The hearing improvement rate at this hospital was 88.1% and the perforation closure rate was 89.2%, which was comparable to other reports. Hearing results are often reported to be worse for type III tympanoplasty as compared to type I tympanoplasty and for type IV tympanoplasty as compared to type III tympanoplasty, and the present results are consistent with previous reports. Since 2012, our decision to perform atticotomy aggressively for patients with restricted movement of the ossicles was appropriate, both in terms of the efficacy and safety. No relationship was found between the size of the perforation and the perforation closure rate.
