Titanium ossicular chain reconstruction in single stage canal wall down tympanoplasty for chronic otitis media with mucosa defect.

Abstract

PURPOSE\nTo evaluate surgical outcomes for chronic otitis media with mucosa defect underwent titanium ossicular chain reconstruction (OCR) in single stage canal wall down tympanoplasty (CWD).\n\n\nMETHODS\nA clinical retrospective study was performed on 83 cases of the chronic otitis media with mucosa defect and 123 ears with mucosa integrity according to intraoperative findings that underwent synchronous titanium OCR in single stage CWD form January 2012 to January 2018. Pre- and postoperative air conduction threshold (AC), air-bone gap (ABG) and ABG closure at 0.5, 1, 2, and 4\u202fkHz were investigated.\n\n\nRESULTS\nThe overall mean AC threshold of 53.4\u202f±\u202f16.5\u202fdB was lowered to 41.2\u202f±\u202f15.9\u202fdB postoperatively (p\u202f<\u202f0.01). The mean pre- and postoperative ABG of all patients were 27.9\u202f±\u202f9.9\u202fdB and 17.2\u202f±\u202f9.3\u202fdB (p\u202f<\u202f0.01), respectively, with a mean ABG closure of 10.7\u202f±\u202f8.4\u202fdB. The total rate of success, postoperative ABG\u202f≤\u202f20\u202fdB was achieved in 71.4%. In the mucosa defect group underwent TORP, the mean pre- and postoperative ABG were 28.1\u202f±\u202f9.8\u202fdB and 20.1\u202f±\u202f9.0\u202fdB (p\u202f<\u202f0.01), respectively, with the ABG closure was 8.0\u202f±\u202f7.9\u202fdB. In the mucosa defect group underwent PORP, the mean pre- and postoperative ABG were 27.9\u202f±\u202f10.1\u202fdB and 16.5\u202f±\u202f9.1\u202fdB (p\u202f<\u202f0.01), respectively, with the ABG closure was 11.4\u202f±\u202f8.6\u202fdB. Furthermore, in the mucosa defect group, there was significant difference in success rate of achieved postoperative ABG\u202f≤\u202f20\u202fdB between the TORP (48.9%) and PORP (77.5%) (p\u202f<\u202f0.05).\n\n\nCONCLUSION\nIt is revealed PORP in single stage CWD tympanoplasty for the patients suffered from chronic otitis media with mucosa defect is favored.