Abstract
Background and Objectives: chronic otitis media is defined as irreversible inflammatory changes in the middle ear and mastoid bone; leading to otorrhea, hearing loss and numerous intracranial and intratemporal complications.Surgical techniques for the treatment of this disease are staged and performed by at least 6 months intervals .Generally after irradication of the infectious process in the first step,ossicular reconstruction is performed in subsequent stages. Unfortunately due to cultural and economic poverty, most patients refuse multiple admissions and continue to live with their hearing loss. The purpose of this study was to merge multiple stages of surgery and perform single stage ossicular reconstruction by remnants of the patient,s ossicles or pieces of the mastoid cortex.
Materials and Methods: In this study, 33 patients admitted to the Otorhinolaryngology ward of Imam khomeini Hospital in Tabriz between 2003 -2004, underwent audiometric testing and subsequent surgery. Then results of audiometry 4 months after surgery were compared with preoperative values and analyzed by Wilcoxon test for two related samples SPSS 11/00.
Results: In 16 patients tympanomastoidectomy and in 17 patients tympanoplasty was performed.Ossicular reconstruction was performed by the mastoid cortex in 5, sculptured malleus in 1 and sculptured incus in 27 patients. Mean follow- up time was 4 months postoperatively. Mean air bone gap(average gap between bone conduction thresholds and air conduction thresholds at 500Hz,1000Hz,2000Hz) was 47 dB before surgery. Mean speech reception threshold was 58dB before surgery. Postoperatively, mean air bone gap was 15dB and mean speech reception threshold was 25 dB (p<0.05). Air bone gap postoperatively was less than 20 dB in 25 patients and greater than 20 dB in 8 other patients .
Conclusion: Single stage ossicular reconstruction by autologous material is a safe and effective method for the restitution of the sound transmitting system in patients with chronic otitis media.