RESUMO
CONCLUSION: We invented a new ossicular chain reconstruction by lever methods (OCRLM) in tympanoplasty type III with the canal wall down technique and investigated the postoperative hearing results of the 24 patients who had undergone this surgery. Postoperative air-bone gaps (ABGs) followed up for 2.1-3.2 years gave satisfactory improvement audiometrically compared with former reports. OBJECTIVE: To present newly devised methods applied from the viewpoint of mechanical dynamics for ossicular chain reconstruction in tympanoplasty. MATERIALS AND METHODS: A total of 24 cholesteatoma patients who underwent tympanoplasty with mastoidectomy using the canal wall down technique and ossicular chain reconstruction with OCRLM between May 2003 and April 2004 were investigated. The postoperative ABG of a four-frequency (0.5, 1, 2, and 4 kHz) average of OCRLM followed up for 2 years or more was assessed. RESULTS: Patients who underwent OCRLM showed good postoperative hearing results. Average postoperative ABGs of less than 10, 15, 20, 25, and 30 dB were 4.2, 37.5, 70.8, 91.6, and 100%, respectively. A gap of >30 dB was absent and the mean postoperative ABG was 17.2dB. The OCRLM method was satisfactory to improve hearing and effectively reduce the ABG postoperatively over the period of observation.
