We reviewed the postoperative hearing results in 32 ears that were underwent type IV tympanoplasty between 1995 and 2005 at Kurume University Hospital.
Hearing results were analyzed depending on the type of ossicular chain reconstruction, type of the columella, difference in canal resection and staged surgery using the guide line for hearing results following middle ear and mastoid surgery by the Otological Society of Japan (2000). The that society defined successful hearing results were as follows; The difference between air conduction and bone conduction is less than 15dB or the postoperative hearing level is less than 30dB or the hearing gain is more than 15dB.
Overall success rate of surgery was 63%. The success rate of cases in which the columella was made from auricular cartilage was significantly poorer as compared to cases of autografted or artifical ossicles. The hearing outcome after staged surgery was significantly better than that after of ossicular chain reconstruction performed during the initial surgery.