Lower Intact-Bridge Tympanomastoidectomy with Preservation of Ossicular Chain / 听力学及言语疾病杂志

ABSTRACT

Objective To reduce the recurrence rate and improving the hearing recovery effect in chronic otitis media patients with obstructive lesions in the attic, through the low bone intact-bridge tympanomastoidectomy.Methods A total of 23 patients with little severe or severe localized attic lesions granulation wrapped in ossicular chain blocking the entrance of tympanic antrum or affecting the attic drainage were included in this study.We have modified the intact-bridge tympanomastoidectomy to low bone intact-bridge tympanomastoidectomy (At the tympanic antrum entrance and lateral attic wall, we retained a more narrow low bone bridgestructure), completely cleared the localized lesions, released the activities limited ossicular chain and unobstructed the attic and middle tympanum drainage channel.And patients were followed up for 0.5~3 years.Results Before operations, the average pure tone auditory hearing threshold of all 23 patients was 43.91±9.90 dB HL,the preoperative air-bone gap was 24.04±5.10 dB.While the postoperative stable pure tone hearing test results were 33.17±7.63 dB HL and 14.70±4.52 dB, respectively.All patients had postoperative dry ear within 3 months.There was no recurrence of tympanic membrane perforation during follow-up.One patient had tympanic effusion(secretory otitis media) had accepted grommet insertion, 6 months after T-tube insertion, the tube was removed, and was followed up to 1 year.Conclusion The low bone intact-bridge tympanomastoidectomy by preservation of low bone bridge used in patients with chronic otitis media and obstructive lesions in the attic middle tympanum could reduce the recurrence rate and improve the recovery of hearing.