Impact of Intraoperative Findings on Hearing in Revision Ear Surgery

Introduction: Hearing results after chronic ear surgery encompass recurrence, localization and extent of cholesteatoma, type of surgery, ossiculoplasty methods, but rarely interpret intraoperative findings. This study aimed to analyze the impact of intraoperative findings in revision tympanomastoidectomy in predicting postoperative hearing. Materials and Methods: This was a retrospective non-randomized cohort of ۱۰۱ patients treated for recurrent chronic otitis media by tympanomastoidectomy. The patients’ demographics, localizations of disease recurrence and perioperative hearing results were analyzed. Results: Logistic regression showed that presence of tympanic perforation (p=۰.۰۳۶), ossicular chain damage (p=۰.۰۰۶), were negatively associated with improved hearing postoperatively. Attic cholesteatoma was associated with better postoperative hearing (p=۰.۰۴۵). Presence of tympanic perforation (p=۰.۰۵۰), alongside perifacial localization of imflammation (p=۰.۰۲۱) and ossicle destruction (p=۰.۰۱۳) were associated with worse postoperative hearing results. Multivariate analysis confirmed that tympanic perforation (p=۰.۰۴۰, F=۴.۴۰۱), and ossicular chain involvement (p=۰.۰۲۵, F=۵.۲۴۹), were consistent negative predictors of hearing improvement, while postoperative deterioration of hearing was associated with tympanic perforation (p=۰.۰۳۸, F=۴.۴۶۵) and facial nerve dehiscence (p=۰.۰۴۵, F=۴.۱۶۰). Conclusions: Comparison of postoperative revision tympanomastoidectomy hearing outcomes revealed significant positive reductions in air-bone gap values, primarily at low and mid frequencies. Postoperative hearing results  at high frequencies are not affected by revision surgery.

کلیدواژه ها:

Chronic otitis media ، Cholesteatoma ، Hearing outcomes Revision ear surgery ، Tympanomastoidectomy