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Tympanoplasty with intact canal wall mastoidectomy for cholesteatoma: Long‐term hearing outcomes
Author(s) -
Wilson Kevin F.,
London Nyall R.,
Shelton Clough
Publication year - 2013
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.24202
Subject(s) - tympanoplasty , cholesteatoma , mastoidectomy , medicine , term (time) , audiology , ear canal , surgery , radiology , physics , quantum mechanics
Objectives/Hypothesis To review long‐term hearing results after intact canal wall mastoidectomy with tympanoplasty for treatment of cholesteatoma and to identify factors associated with improved hearing outcomes. Study Design A retrospective analysis of all cases of cholesteatoma treated with intact canal wall mastoidectomy at a single institution by the senior author over a period of 9 years, for which at least 2 years of follow‐up data exist. Methods Patient and disease information was collected retrospectively and analyzed. Results There were 148 patients with 156 affected ears treated and followed for a median of 5.3 years (interquartile range, 3.6–7.4 years). The majority of the operations (144/156, 92%) were staged. Hearing data were available for 150 ears. The overall postoperative mean air‐bone gap was ≤20 dB in 64% of patients. This was maintained long term in most patients, with 59% of patients still with an air‐bone gap ≤20 dB at a median follow‐up of 5.3 years. The presence of an intact stapes did not affect initial hearing outcomes, but the group with an intact stapes had improved long‐term hearing results compared to those without an intact stapes (71% vs. 42% air‐bone gap ≤20 dB, P < .001). The presence of a malleus handle also led to superior long‐term hearing outcomes (72% vs. 48% air‐bone gap ≤20 dB, P = .005). Conclusions Long‐term hearing results from intact canal wall mastoidectomy with tympanoplasty are excellent, with the majority of patients maintaining a small air‐bone gap long term. The presence of a stapes and/or malleus handle confers improved long‐term hearing outcomes. Level of Evidence 4. Laryngoscope , 123:3168–3171, 2013