Kronik otitis mediada ossiküloplasti tekniklerine göre işitme sonuçları
Adil Eryılmaz1, Melek Uyar2, Oğuzhan Oğuz3, Ayşe İriz4, Süleyman Boynueğri1, Aydın Acar1, Altan Kaya5, Nihal Geçgil6
1Ankara Numune Eğitim Ve Araştırma Hastanesi Kulak Burun Boğaz Hastalıkları Kliniği, Ankara, Türkiye
2Haseki Eğitim Ve Araştırma Hastanesi Kulak Burun Boğaz Hastalıkları Kliniği, İstanbul, Türkiye
3Siirt Kurtalan Devlet Hastanesi Kulak Burun Boğaz Kliniği, Siirt, Türkiye
4Gazi Üniversitesi Tıp Fakültesi Kulak Burun Boğaz Anabilim Dalı, Ankara, Türkiye
5Kayseri Eğitim Ve Araştırma Hastanesi Kulak Burun Boğaz Hastalıkları Kliniği, Kayseri, Türkiye
6Ankara Numune Eğitim Ve Araştırma Hastanesi Kulak Burun Boğaz Kliniği Odyoloji Bölümü, Ankara, Türkiye
Keywords: Air-bone-gap, bone cement, chronic otitis media, ossiculoplasty.
Abstract
OBJECTIVE: This study aims to evaluate the variables which affect hearing results in ossiculoplasty in patients with chronic otitis media.
METHODS: Fifty-two patients who underwent ossiculoplasty surgery due to chronic otitis media between January 2010 and July 2011 were retrospectively analyzed. The effects of the ossicular residue and selected ossiculoplasty techniques on hearing were compared. Air-bone-gap (ABG) levels were determined both preoperatively and postoperatively. Postoperative ABG levels ≥20 dB were considered successful. Bone cement technique was reviewed in terms of specific superiority from other techniques.
RESULTS: Ossiculoplasty was applied only 36% of patients operated due to chronic otitis media. Postoperative ABG levels were <20 dB in 26.9% (n=14) of patients. The mean postoperative ABG level was 23.5±9.9 in patients with an intact stapes suprastructure and 33.7±10.1 in those without an intact stapes suprastructure (p=0.001). The best surgical results were found to be 17.1±9.4 dB in patients with an intact malleus handle undergoing bone cement ossiculoplasty (p=0.048).
CONCLUSION: In this study, we conclude that status of malleus handle is the most important factor which influence the success of ossiculoplasty. Hearing results were positive with bone cement technique at least conventional techniques. We consider that the usage of bone cement technique may rule out absorption and extraction of ossiculoplasty material-related problems in selected cases.