Abstract
Objectives
A technique for providing long-term ventilation of the middle ear (ME) during staged tympanoplasty is described, and the results using this treatment in patients with chronic Eustachian tube dysfunction (ETD) are reported.
Methods
Retrospective, nonrandomized case review. All operations were performed by the same surgeon (author). 26 consecutive patients who underwent staged tympanoplasty with ETD have been followed up and and examined for more than 5 years. Adhesive otitis media, cholesteatoma, and cholesterol granuloma were included in this study. All patients had a T-tube placed at the first stage tympanoplasty for long-term ventilation of the middle space. The 3 main outcome measures were inflammation control, hearing improvement, and recurrence of the disease.
Results
6 had adhesive otitis media, 16 had cholesteatoma, and 4 had cholesterol granuloma. All patients underwent planned first stage tympanoplasty with simultaneous ventilation tube placement; 12 underwent concomitant ossiculoplasty, and 22 underwent mastoidectomy. 2 patients (1 cholesteatoma and 1 cholesterol granuloma) had recurrence. 2 patients with adhesive otitis media had intermittent otorrhea (with maintained ventilation tube). In patients who underwent planned staged tympanoplasty with tube placement, the success rate both in inflammation control and in hearing improvement was higher.
Conclusions
The simultaneous placement of the long-term ME ventilation tube during planned staged tympanoplasty is a simple, safe, and effective alternative for longer-term ME ventilation in patients with severe ETD. Staged tympanoplasty technique with ventilation tube is effective and available for the treatment of adhesive otitis media, cholesteatoma, and cholesterol granuloma.
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