ABSTRACT
The aim of this study was to report our experience with cartilage tympanoplasty (CT) in smokers and compare it with that of non-smokers using a retrospective chart review at a tertiary referral center. Between September 2008 and September 2010, cartilage tympanoplasty was performed in 52 patients. Among them, 27 were active smokers and 25 former or non-smokers. The entire tympanic membrane was replaced with conchal cartilage, shaped either as a shield for cases with intact canal wall mastoidectomies, or crashed for cases with canal wall down procedures. The mean post-operative follow-up was 12 months (range 6-18 months). A complete pre- and post-operative audiologic evaluation was obtained in all patients. Graft take was successful in all patients. The overall average pre-operative and post-operative pure tone average air-bone gaps (PTA-ABG) was 52.2 dB ± 17.7 dB and 35.4 dB ± 17.9 dB, respectively, with an overall improvement of 16.8 dB (p < 0.001). A post-operative PTA-ABG of 25 dB or less was achieved in 39 (75 %) patients (p < 0.001). In smokers, the hearing improvement was 17.6 dB (p < 0.001) with a PTA-ABG of 25 dB or less in 19 (70 %). In non-smokers, the average hearing improvement was 16.8 dB (p < 0.0005) with a post-operative PTA-ABG of 25 dB or less in 19 (76 %), (p < 0.001). The results showed that the CT technique is a very effective procedure for smokers. Excellent graft take and satisfactory hearing results can be accomplished regardless of smoking habits.
Subject(s)
Cartilage/transplantation , Smoking , Tympanic Membrane Perforation/surgery , Tympanoplasty/methods , Adolescent , Adult , Aged , Aged, 80 and over , Audiometry, Pure-Tone , Case-Control Studies , Ear Auricle , Female , Humans , Male , Middle Aged , Retrospective Studies , Treatment Outcome , Young AdultABSTRACT
OBJECTIVE: To evaluate the correlation between caloric and vestibular evoked myogenic potential test results, initial audiogram data, and early hearing recovery, in patients with idiopathic sudden hearing loss. MATERIALS AND METHODS: One hundred and four patients with unilateral idiopathic sudden hearing loss underwent complete neurotological evaluation. Results for vestibular evoked myogenic potential and caloric testing were compared with patients' initial and final audiograms. RESULTS: Overall, abnormal vestibular evoked myogenic potential responses occurred in 28.8 per cent of patients, whereas abnormal caloric test results occurred in 50 per cent. A statistically significant relationship was found between the type of inner ear lesion and the incidence of profound hearing loss. Moreover, a negative correlation was found between the extent of the inner ear lesion and the likelihood of early recovery. CONCLUSION: In patients with idiopathic sudden hearing loss, the extent of the inner ear lesion tends to correlate with the severity of cochlear damage. Vestibular assessment may be valuable in predicting the final outcome.
