A Clinical Study of the Ossiculoplasty in the Chronic Otitis Media / 대한이비인후과학회지

ABSTRACT

Reconstruction of the middle ear conduction mechanism continues to pose a significant challenge to the otolaryngologist. To investigate the suitable material and surgical method to get optimal hearing gain in the middle ear surgery, two hundred and twenty-two cases of different kind of ossiculoplasty in patients suffering from chronic middle ear disease at the Severance hospital and Soh's ENT clinic from January 1989 to December 1994 were included in this retrospective study and we reviewed the previous reports about the ossiculoplasty at the department of otolaryngology, Yonsei University College of Medicine from January 1981 to December 1988. A successful hearing gain was defined as a post-operative air-bone gap of cartilage were successful, 58.2 per cent of the ceravital, 64.8 per cent of the ossicle, 74.6 percent of polycel, and 81.0 per cent of the hydroxylapatite. It is obvious that the hydroxylapatite produced the best results, while there was no statistical difference, regarding the hearing improvement, between the open cavity mastoidectomy and the intact canal wall mastoidectomy techniques and between the one staged ossiculoplasty and the two staged ossiculoplasty. 72.4 percent of ossiculoplasty cases in the state of the patent eustachian tube orifice were successful and 57.9 percent of the obstructed eustachian tube orifice were successful. The common causes of failure were lateral healing and dislocated drum graft material, fibrous adhesion and fixation, infection, and extrusion of the graft material.