Hearing Reconstruction And Influencing Factors Of Chronic Otitis Media After A Tympanoplasty

Objective: To explore the effects and influencing factors of hearing reconstruction after tympanic tympanoplasty.Methods: Seventy patients with chronic otitis media who underwent surgical treatment at the Department of Otorhinolaryngology in our hospital from June 2008 to September 2019,including 23 males and 47 females;youngest 18 years old,maximum 66 years old,average age 39 years;left 18 cases of middle ear cholesteatoma,20 cases of left chronic suppurative otitis media,12 cases of right middle ear cholesteatoma,and 20 cases of right chronic suppurative otitis media;follow-up time was 3 to 88 months,with an average of 17 months.All patients were treated with mastoidectomy and tympanoplasty,including 3 cases of upper tympanotomy + tympanoplasty,2 cases of bridge mastoidectomy + tympanoplasty,and wall mastoidectomy + tympanoplasty.25 cases were treated with open mastoidectomy + tympanoplasty;24 cases were performed with type I tympanoplasty;42 cases were performed with type II tympanoplasty;4 cases were performed with type III tympanoplasty;tympanic membranes were repaired with temporal muscle fascia Of the 29 cases,41 cases used the tragus cartilage-perichondral complex.Calculate the airbone gap before and after the operation,that is,the difference between the average values of air conduction and bone conduction at 4 frequencies of 500 Hz,1 KHz,2 KHz,and 4 KHz.To be effective,it belongs to the effective group.If it is greater than 20 d B,it is invalid.It belongs to the invalid group.Results: The number of effective cases was 42 and the number of invalid cases was 28.The effective rate was 60%.Pre-and postoperative air-bone conduction distances were analyzed by paired t-test and linear correlation analysis.There was a significant difference(t = 6.579,p = 0.000 <0.05)and a significant correlation(c2 = 0.260,p = 0.030 <0.05).).Postoperative hearing effects(ie,effective and ineffective)were used as dependent variables.Patient gender,patient age,duration of disease,follow-up interval,type of otitis media,type of surgery,type of tympanic formation,and repair materials were used as independent variables.Logisitic regression analysis was performed.Factors affecting the postoperative hearing effect were found(p> 0.05).Conclusion: The majority of patients benefit from a one-stage hearing reconstruction,and some patients have poor hearing reconstruction.The cause of this need to be further studied.