Factors Affecting Chronic Suppurative Otitis Media Following Wall-down Tympanoplasty

Objective To study the hearing efficacy of chronic suppurative otitis media following wall-down tympanoplasty (radical mastoidectomy+tympanoplasty+ear cavity angioplasty), and to analyse the factors in the pre-and post-operation.Methods All the forty-seven cases(47ears) of chronic suppurative otitis media that underwent wall-down tympanoplasty, we used erythromycin ointment and antibiotic gauze for stuffing. After14days we began to dress, three times a week The average time of dry ear was about three months. Detecting the average air conduction hearing threshold (0.5Hz,1Hz,2Hz) before the operation and afrer dry ear,we used T test to analyse five possible factors (existence of stapes, open of posterior tympanum, the existence of labyrinthine fistula,breaking of sinuses sigmoideus, breaking of tympanic roof) about hearing.Results Preoperative air conduction hearing threshold was (45.2±8.0) dB, preoperative bone conduction hearing threshold was (32.2±15.2) dB, preoperative air-bone gap was (15.2±9.4) dB; postoperative air conduction hearing threshold was (66.4±7.8) dB, postoperative bone conduction hearing threshold was (41.4±8.9) dB. postoperative air-bone gap was (13.7±13.1) dB. postoperative air conduction hearing threshold declined21.2±0.2dB compared with preoperative air conduction hearing threshold, it had statistically significant difference after the T-test(P＜0.05); postoperative bone conduction hearing threshold decline9.2±5.3dB compared with preoperative bone conduction hearing threshold, it had no statistically significant difference after the T-test(P＞0.05); postoperative air-bone gap declined3.6±2.5dB compared with preoperative air-bone gap, it had no statistically significant difference after the T-test(P＞0.05).Conclusion Auditory results after wall-down tympanoplasty were influenced by multiple factors, existence of stapes and backplane, protecting the vestibular window, repairing the labyrinthine fistula and cleaning the posterior tympanum were the main factors affecting the hearing after the wall-down tympanoplasty.