Air-bone gap in ears with a well-repaired tympanic membrane after Type III and Type IV tympanoplasty

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• 作者：Masahiro Okada ; Kiyofumi Gyo ; Taro Takagi ; Takashi Fujiwara ; Hirotaka Takahashi ; Nobuhiro Hakuba ; Naohito Hato
• 关键词：Ossicular reconstruction ; Columella ; Aeration of tympanic cavity ; Stapes mobility ; Middle ear mechanics
• 刊名：Auris Nasus Larynx
• 出版年：April, 2014
• 年：2014
• 卷：41
• 期：2
• 页码：153-159
• 全文大小：1985 K

文摘

Objective

To investigate the air-bone conduction hearing gap (A-B gap) after Type III and Type IV stapes columella tympanoplasty in ears with mobile stapes and a well repaired tympanic membrane (TM).

Methods

Those patients who underwent tympanoplasty in our hospital between 2003 and 2009 and satisfied the following criteria were eligible: (1) good stapes mobility, confirmed intraoperatively; (2) postoperative TM and/or computed tomography (CT) findings that showed a well-aerated tympanic cavity without TM perforation, otorrhea, or middle ear effusion; and (3) measurable air and bone conduction hearing thresholds 1 year postoperatively at all test frequencies (250 Hz, 500 Hz, 1 kHz, 2 kHz, and 4 kHz).

Results

Hearing results were better after Type III tympanoplasty than after Type IV tympanoplasty. After Type III (n = 70) and Type IV (n = 24) tympanoplasty, the respective mean A-B gaps were 16.4 卤 7.2 dB and 20.1 卤 5.6 dB, respectively. The mean A-B gap was significantly smaller after Type III tympanoplasty than after Type IV tympanoplasty (p < 0.05). Regardless of the type of tympanoplasty, the postoperative A-B gap was greatest at 4 kHz.

Conclusion

The mean A-B gap was smaller after Type III tympanoplasty than after Type IV tympanoplasty. The magnitude of the A-B gap was greatest at 4 kHz in both procedures.