Silastic sheets in tympanoplasty: hearing outcome

ABSTRACT

Chronic inflammation of the middle ear is one of the most common diseases affecting population in our locality. Surgical managements of this disease sometimes result in the development of middle ear adhesions and hearing deterioration and communication disorders. This study included 106 selected subjects suffering from chronic otitis media [suppurative and non suppurative]. Selection depended on intraoperative findings which included the presence of adhesions and intact ossicles. Cases with ossicular necrosis, cholesteatoma, granulation tissues and tympanosclerosis were excluded. The studied subjects were classified into 2 groups. The first group [74 patients] underwent single stage tympanoplasty with insertion of silastic sheets [0.127 mm thick on the medial wall. lateral to incus long process and between the incus and malleus]. In cases of opening the mastoid cavity a tube like silastic sheet was inserted in the aditus to avoid adhesions and to allow good ventilation. The second group [32 patients] underwent single stage tympanoplasty without silastic sheets insertion. Subjects of the two groups were audiologically evaluated preoperatively and 1 month, 6 months and one year postoperatively. The first group showed better air conduction and bone conduction averages one year postoperatively when compared to those of the second group. The difference was statistically significant. One can conclude that silastic sheets are inert and can prevent the recurrence or formation of adhesions in the middle ear cavity, as reflected by stably improved hearing. Therefore, it would be recommended to use silastic sheets in tympanoplasty for restoration and maintenance of hearing