Predictors of anatomical and functional outcomes following tympanoplasty: A retrospective study of 413 procedures

Zhu, Xiaohui; Yong-li, Zhang; Xue, Ruoyan; Xie, Meng-Yao; Tang, Qi; Yang, Hua

doi:10.1002/lio2.689

Cited by 5 publications

(3 citation statements)

References 25 publications

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“…A good aeration of the middle ear and mastoid cells is known to be a good predictive factor for tympanoplasty success. 1,4,8 Traditionally, this aeration could be evaluated through some measurements in a three-dimensional volume reconstruction CT scan. 6,9 Recent studies by Kim et al and Epprecht et al demonstrated that, when the mastoid antrum is patent, there is a good correlation between middle ear and mastoid cells volume measurements done with three-dimensional volume reconstructions CT scan or calculated with the interaural volume differences with tympanometry.…”

Section: Discussionmentioning

confidence: 99%

Could tympanometric volume be a useful tool to predict the success of type I tympanoplasty in simple chronic otitis media

Ribeiro

Azevedo

Miranda

et al. 2023

Int J Otorhinolaryngol Head Neck Surg

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Background: Middle ear aeration level is an important precursor of chronic otitis media (COM) and one predictive factor for tympanoplasty success. Tympanometry measures the volume of the external ear canal, middle ear cavity, aditus, and mastoid air cells in patients with tympanic membrane (TM) perforation. The aim of the study was to determine whether the pre-operative tympanometric volume and the interaural tympanometric volume differences in unilateral simple COM can predict the success of type I tympanoplasty. Methods: Retrospective analysis of type I tympanoplasties performed in adults between January 2017 and December 2020 in a tertiary hospital. Bilateral COM, revision surgery and tympanoplasty using cartilage grafts or associated with other procedures were excluded. Success was defined as no evidence of TM perforation on otoscopic examination and tympanogram, at least six months after surgery. Results: Sixty-one patients were evaluated. The mean age was 43 years old, and there was a female predominance (55.7%). The overall success rate was 77%. Location or size of perforation weren’t different among patients with and without surgical success. We found a statistically significant result (p=0.009) regarding interaural tympanometric volume differences, with a median of 2.7 ml (IQR 3.6) in the surgical success group and a median of 1.3 ml (IQR 1.26) in the recurrence group. 90.6% of patients with interaural tympanometric volume difference greater than 2 ml had successful surgery. Conclusions: A good aeration of middle ear, demonstrated by higher interaural tympanometric volume differences, can predict success of type I tympanoplasty.

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Section: Discussionmentioning

confidence: 99%

Could tympanometric volume be a useful tool to predict the success of type I tympanoplasty in simple chronic otitis media

Ribeiro

Azevedo

Miranda

et al. 2023

Int J Otorhinolaryngol Head Neck Surg

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“…Pre‐ and postoperative air‐bone gaps (ABGs) were collected. Functional success, described as a postoperative ABG <20 dB, was also extracted 34,35 …”

Section: Methodsmentioning

confidence: 99%

Outcomes of Tympanoplasty After Cleft Palate Repair: A Systematic Review and Meta‐analysis

Poupore

Smaily

Carroll

et al. 2022

Otolaryngol.--head neck surg.

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Objective To analyze graft success rates and hearing outcomes in patients with a history of cleft palate (CP) repair undergoing tympanoplasty. Data Sources PubMed, Scopus, and CINAHL. Review Methods Per PRISMA guidelines, the databases were searched from date of inception through December 14, 2021. Studies of patients with previous CP repair who underwent tympanoplasty were included. Meta-analysis of proportions, continuous measures, odds ratios (ORs), and meta-regression were used to analyze graft success and hearing outcomes after tympanoplasty. Results A total of 323 patients with CP repair and 1169 controls were included. The proportion of graft success was 86.7% (95% CI, 76.1%-94.5%) in patients with CP repair and 88.8% (95% CI, 76.9-96.8) in controls. There was no difference in odds of graft success between patients with CP repair and controls (OR, 1.0 [95% CI, 0.5-1.8]; P = .870). Age was not a significant moderator of graft success in patients with CP repair ( r = 0.1 [95% CI, −0.2 to 0.3]; P = .689) or controls ( r = −0.0 [95% CI, −0.1 to 0.1]; P = .952). Comparing mean differences between pre- and postoperative air-bone gap was not statistically significant in patients with CP repair and controls (0.2 dB [95% CI, −3.1 to 3.4]; P = .930). Odds of functional success (postoperative air-bone gap <20 dB) were not different between the groups (OR, 0.8 [95% CI, 0.5-1.4]; P = .450). Conclusion This meta-analysis does not endorse anatomic or functional differences between patients with CP repair and controls after tympanoplasty. However, there is a paucity of evidence for younger children. Further studies are warranted to elucidate specific risk factors for tympanoplasty outcomes in young patients with previous CP repair.

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“…Во многих клинических исследованиях оцениваются факторы, влияющие на эффективность тимпанопластики [47][48][49][50]. Однако отсутствие стандартизации при прогнозировании результатов тимпанопластики препятствует сравнению результатов по учреждениям [51][52][53][54][55]. Все вышесказанное входит в рабочие программы и преподается врачам, студентам и ординаторам на практических занятиях, курсах повышения квалификации и дополнительного профессионального образования [56].…”

Section: Introductionunclassified

Personalized prediction of the results of reconstructive surgery for chronic otitis media

et al. 2022

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Introduction. The goal of the surgical treatment of patients with chronic otitis media is to eliminate the consequences of the inflammatory and destructive disease while preserving the anatomy of the middle ear and improving auditory function. According to the literature, the outcome of middle ear reconstructive surgery for the surgeon and the patient in most cases remains unpredictable. The development of an integrated approach to predicting the results of reconstructive sanitizing surgery will make it possible to select the most effective surgical tactics in terms of treatment time and type of surgical intervention.Aim. To develop a methodology for personalized prediction of the result of operations on the temporal bone in patients with chronic otitis media and substantiate the choice of optimal surgical tactics, taking into account clinical and functional parameters.Materials and methods. A retrospective study was carried out to compare the data of patients with the use of the author’s personalized prognosis method: “A method for predicting the result of tympanoplasty” and “A method for predicting the degree of hearing loss in otosurgery for chronic otitis media” with the results of surgical treatment of 263 patients with chronic otitis media, operated on in hospitals in Moscow. Chelyabinsk in 2018–2020.Results and discussion. In the observation, the patients were divided into two groups according to the sum of points, which determined the volume, type and timing of the operation. The sum of points less than or equal to 20 was assessed as a favorable prognosis for reconstructive debridement surgery. The sum of points in the range from 21–40 was assessed as the possibility of carrying out onestage surgery for the purpose of sanitation and reconstruction, but the patient should be informed about the unfavorable prognosis for the restoration of hearing. A score greater than 40 is assessed as an unfavorable prognosis, with an indication for separate-stage surgery, indicating a socially significant hearing loss in the postoperative period in patients with chronic otitis media.Conclusion. A personalized approach to predicting the results of surgical treatment forms groups of patients with chronic suppurative otitis media and helps in choosing surgical tactics in terms of the type, volume and timing of one-stage or separatestage reconstructive surgery and the need for reoperation for a period of one year.

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Predictors of anatomical and functional outcomes following tympanoplasty: A retrospective study of 413 procedures

Cited by 5 publications

References 25 publications

Could tympanometric volume be a useful tool to predict the success of type I tympanoplasty in simple chronic otitis media

Could tympanometric volume be a useful tool to predict the success of type I tympanoplasty in simple chronic otitis media

Outcomes of Tympanoplasty After Cleft Palate Repair: A Systematic Review and Meta‐analysis

Personalized prediction of the results of reconstructive surgery for chronic otitis media

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