We conducted a retrospective survey of 371 ears operated on over a ten-year period from 1989 to 1998. All of the surgical procedures were performed by the same surgeon. Data included 260 ears with chronic otitis media (OMC) and 111 ears with middle ear cholesteatoma (CHOLE). The success rate of the surgery was analyzed using the three criteria suggested by the Japan Clinical Otology Committee in 1999. The procedure was classified as successful when the hearing level at 6 months after surgery met at least one of these three conditions: 1) a hearing level above 30dB, 2) a gain of more than 15dB, or 3) an air-bone gap of less than 15 dB. We used the autograft cartilage for a columella for ossicular reconstruction. Staged operation was not included in this study.
In case of OMC, 209 ears recieved type I tympanoplasty, 45 ears modified type III, 6 ears modified type IV. In case of CHOLE, 31 ears recieved type I tympanoplasty and 67 ears modified type III, 13 ears modified type IV.
In case of OMC the success rates were 83.7% for type I, 75.6% for modified type III and 16.7% for modified type IV tympanoplasty.
In case of CHOLE the success rates were 87.1% for type I, 73.1% for modified type III and 46.2% for modified type IV tympanoplasty.
The characteristics of the unsuccessful cases were examined. The causes of the unsuccessfull results in hearing improvement were the following, severe sensorineural deafness, the stapes adhesion, ossicular destruction due to a large cholesteatoma and severe inflammation around the stapes.
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