Clinical Characteristics and Surgical Benefits and Problems of Chronic Otitis Media and Middle Ear Cholesteatoma in Elderly Patients Older Than 70 Years

Shinnabe, Akihiro; Hara, Mariko; Hasegawa, Masayo; Matsuzawa, Shingo; Kanazawa, Hiromi; Yoshida, Naohiro; Iino, Yukiko

doi:10.1097/mao.0b013e31825f24ba

Cited by 12 publications

(6 citation statements)

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“…It is characterized by sclerotic and hyaline degeneration of the submucosal collagen layer of the middle ear [19] and can result in ossicular chain transection or fixation. In the present study, Wullstein type I was the most commonly performed tympanoplasty in patients of all ages with chronic perforated otitis media, which was consistent with previous reports [2,4,20] . We also found the proportions of Wullstein types III and IV tympanoplasty to be significantly higher in the elderly group than in the middle group, as suggested by a previous report that found that the proportion of patients undergoing Wullstein type III with columella increased with age [20] .…”

Section: Discussionsupporting

confidence: 81%

“…Many researchers have investigated the relationship between age and the results of tympanoplasty in chronic otitis media [1,2] . Tympanoplasty in elderly patients is acceptable nowadays, and some have noted that postoperative hearing results are significantly improved in elderly patients and that there are no disadvantages in results compared to younger patients [3,4] , although preoperative bone-conduction thresholds gradually worsen with age. It is, however, often recognized during the operation that tympanoplasty can be technically more difficult in elderly patients than in younger patients because of severe middle ear conditions, including mucosal inflammation, tympanosclerosis, and destruction of the ossicular chain.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Characteristics of Chronic Perforated Otitis Media in Different Age Groups

Hasegawa

Shinnabe²,

Kanazawa³

et al. 2017

Int Adv Otol

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OBJECTIVE:We aimed to analyze preoperative and intraoperative clinical characteristics of chronic perforated otitis media by patient age. MATERIALS and METHODS:We analyzed 137 tympanoplasties for chronic perforated otitis media in 133 patients. Exclusion criteria were ear adhesions, cholesteatoma, and a history of tympanoplasty. Patients were divided into a younger group (aged 15-39 years), a middle group (40-64 years), and an elderly group (≥65 years). We compared tympanoplasty technique (using Wullstein classification), mastoid air-cell area measured by temporal bone computed tomography, preoperative aeration of the temporal bone, mean preoperative hearing (at 500 Hz, 1000 Hz, and 2000 Hz), and patch effect calculated by the pre-and post-patch air-bone gap at frequencies of 250 Hz and 500 Hz among the three age groups. RESULTS:Although type I tympanoplasty was performed most frequently in all age groups, it was performed significantly less often in the elderly group (p<0.05). The mean mastoid pneumatization index was significantly lower in the elderly group (p<0.05). Preoperative air-conduction hearing and bone-conduction hearing differed significantly among age groups (p<0.05 for both). There were no significant differences in the air-bone gap among the three groups. The mean patch effect was significantly better in the younger group than in middle or elderly groups (p<0.05). CONCLUSION:The less pneumatized mastoid and ossicular diseases in elderly patients with chronic perforated otitis media suggest that they had longer lasting and more severe childhood middle ear pathologies than did younger patients.

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Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Clinical Characteristics of Chronic Perforated Otitis Media in Different Age Groups

Hasegawa

Shinnabe²,

Kanazawa³

et al. 2017

Int Adv Otol

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“…The rate of tympanosclerosis was reported to be 18.6% in patients aged > 70 years by Shinnabe et al [10]. This rate was found to be 5.5% [12] and 11.6% [13] in the adult group.…”

Section: Discussionmentioning

confidence: 89%

“…Some authors reported that age is a significant prognostic factor for the success of tympanoplasty and that almost all tympanoplasty operations over 50 years of age may result in functional failure [9]. Shinnabe et al showed that in elderly patients with chronic otitis media without cholesteatoma, compared to before and after surgery, there was a statistically significant improvement in ABG, and ear discharge disappeared in 98% of patients [10]. Shishegar et al demonstrated in their study; there was no significant relationship between age and the success rate of tympanoplasty [11].…”

Section: Discussionmentioning

confidence: 99%

Significance of the middle ear risk index in predicting tympanoplasty success in the elderly

Sevil

Doblan

2020

Eur Arch Otorhinolaryngol

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Purpose To evaluate the relationship between middle ear risk index (MERI) score and success of tympanoplasty in elderly (≥ 60 years) compared with young patients (18-59 years) and to investigate the prognostic factors affecting the success of tympanoplasty. Methods Patients were subdivided into three subgroups according to the MERI score as follows: mild (0-3), moderate (4-6), and severe (≥ 7). Ages, perforation sides and location, preoperative and postoperative audiological results, and the graft success of 29 patients aged over 60 years were compared with those of 52 patients aged between 18 and 59 years. Results Preoperative and postoperative air conduction, preoperative and postoperative bone conduction, and preoperative and postoperative air-bone gap (ABG) were higher in the older group compared with the younger group (p < 0.05). The hearing gain in the younger group was 12.63 (6.43), and in the older group was 12.66 (7.85), while did not differ significantly between groups (p = 0.689). Results demonstrated that cases with low/moderate score of MERI had a higher graft success rate compared with patients with a high score of MERI (Φ = 0.391; p < 0.001) as well as, patients with low/moderate score of MERI had the lower need for mastoidectomy compared with patients with a high score of MERI (Φ = 0.385; p = 0.001). Conclusion Low/medium MERI scores were the variables that provided realistic expectations and increased the success of tympanoplasty more precisely before surgery. The surgeon will also be able to design an operation strategy as a case study for elderly patients by doing so.

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“…This inclination may be brought about by the expanded surgical (and nonsurgical) options for hearing augmentation following cholesteatoma surgery, 20 and by the increasing reports in the literature of favorable hearing outcomes in elderly patients following tympanoplasty procedures. [21][22][23] In this Australian national hospital database study, there was evidence of an increased adoption of a less invasive approach to the management of cholesteatoma by reference to CWU procedures.…”

Section: Discussionmentioning

confidence: 94%

Incidence and trends of middle ear cholesteatoma surgery and mastoidectomy in Australia—A national hospital morbidity database analysis

Jufas

Forer

et al. 2021

Laryngoscope Investig Oto

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Objective: To investigate the incidence of middle ear cholesteatoma surgery and assess trends in mastoidectomy procedures in Australia. Study design: Cross-sectional population-based study using data from the National Hospital Morbidity Database. Methods: Admitted care episodes containing the principal diagnosis of middle ear cholesteatoma were analyzed for two 12-month periods of 2007-2008 and 2017-2018. Surgical admissions involving mastoidectomy were identified by procedure codes. Incidence rate per 100,000 person-years were compared between study periods.Results: Of the 3855 middle ear cholesteatoma admissions, 3558 (92.3%) involved surgery, with the incidence rate for cholesteatoma surgical admissions estimated at

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Clinical Characteristics and Surgical Benefits and Problems of Chronic Otitis Media and Middle Ear Cholesteatoma in Elderly Patients Older Than 70 Years

Abstract: Tympanoplasty in elderly patients older than 70 years seems to be as safe as when performed in younger patients.

Cited by 12 publications

References 12 publications

Clinical Characteristics of Chronic Perforated Otitis Media in Different Age Groups

Clinical Characteristics of Chronic Perforated Otitis Media in Different Age Groups

Significance of the middle ear risk index in predicting tympanoplasty success in the elderly

Incidence and trends of middle ear cholesteatoma surgery and mastoidectomy in Australia—A national hospital morbidity database analysis

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