Abstract
Objectives:
(1) Describe factors related to frequency-specific hearing outcomes after type I tympanoplasty in pediatric patients. (2) Describe the effect of powered bone drilling on frequency-specific hearing outcomes after type I tympanoplasty.
Methods:
Retrospective medical chart review (February 2006 to October 2011) of 492 consecutive pediatric otolaryngology patients undergoing type I tympanoplasty for tympanic membrane (TM) perforation of any etiology at a tertiary-care pediatric otolaryngology practice. Data collected included air conduction at 250 to 8000 Hz, speech reception thresholds, bone conduction at 500 to 4000 Hz, and air-bone gap at 500 to 4000 Hz. Demographic data obtained included sex, age, size, mechanism, location of perforation, and operative repair technique, as well as the use of a powered bone drill during surgery.
Results:
A downtrend in sensorineural hearing at 2000 and 4000 Hz was noted with the use of a powered drill during surgery, although no significant difference in sensorineural hearing or air-bone gap was detected at 500, 1000, 2000, or 4000 Hz (P > .05). No significant change was detected in conductive hearing at 1000, 2000, 4000 Hz, or 8000 Hz (P > .05). Significant improvement was noted in lower-frequency conductive hearing at 250 and 500 Hz (P < .001).
Conclusions:
No correlation between high-frequency hearing loss and use of a powered drill during type I tympanoplasty was found in this pediatric population. Surgery was found to significantly improve conductive hearing at 200 and 500 Hz. Based on these results, use of a powered bone drill is not contraindicated during type I tympanoplasty.
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