Management of Chronic Middle Ear Disease in Only Hearing Ear / 대한이비인후과학회지

ABSTRACT

BACKGROUND AND OBJECTIVES: he objectives of chronic middle ear surgery are two folds control of the disease and preservation of hearing. The surgery for middle ear surgery where only one ear is good is difficult because hearing preservation must be considered more seriously. In this study, we tried to review the preoperative management, surgical indications, and postoperative hearing changes and complications in chronic middle ear disease with only one hearing ear. SUBJECTS AND METHOD: The medical records of 13 patients with only one hearing ear who received operation by the same surgeon from January 1994 to June 2002 were retrospectively reviewed with regards to hearing level and disease control. Preoperative managements including bacteriologic culture for otorrhea and antibiotic medication were performed, and CT scan was used for evaluating bony destruction. Preoperative and postoperative pure tone hearing levels were compared. RESULTS: Compared to the preoperative air conduction hearing level, one case of canal wall-up and one case of canal wall-down procedures presented decreased hearing level postoperatively. During the follow-up period for 1 year, no recurrence was observed except for one case of tympanic membrane perforation, which was resolved after myringoplasty. CONCLUSION: Preoperative therapeutic principles and proper surgical indication are necessary for successful control of the disease and preservation of hearing in the only hearing ear. Also, either canal wall-up or wall-down mastoidectomy can be used for chronic middle ear disease in the only hearing ear. However, it must be kept in mind that even the conservative middle ear surgery does not always guarantee a good outcome in the only hearing ear.