Surgery of the ‘only hearing ear’ with chronic ear disease

Abstract

The management of chronic ear disease affecting the only hearing ear is a controversial subject. The relative scarcity of literature on the subject prompted us to prepare a questionnaire which was sent to European and American otologists and to review 19 cases operated at the ENT Clinic of the University of Parma, Italy, and 16 cases operated at The Baptist Memorial Hospital, Memphis, U.S.A. Surgery of cholesteatoma involving the only hearing ear is advised by all the interviewed otologists without exception, even in the presence of a labyrinthine fistula. The cases from the University of Parma were managed as follows: a classic modified radical mastoidectomy was performed in 10 cases, a staged intact canal wall tympanoplasty was done in four cases, an open tympanoplasty in three and a radical mastoidectomy in the remaining two cases. The cases from The Baptist Memorial Hospital were managed with an intact canal wall tympanoplasty (ICWT) in nine and with an open procedure in seven cases. All the otologists interviewed agreed that surgery of the only hearing ear requires particular attention and experience, and should be performed with extreme care by a very experienced surgeon.

Mastoid Surgery in the Only Hearing Ear

“…In two cases the degree of unremitting discharge in a noncholesteatomatous ear finally led to a decision that surgery was required. Given the known, accepted risk to the inner ear that is associated with surgery of any sort, many authorities have recommended that surgery of the only hearing ear should be carried out in a tertiary referral center 15‐18 . In the senior author's recent study of surgery in 153 tertiary referral cases of modified radical mastoidectomy 8 there were no dead ears and no significant changes in inner ear function.…”

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

“…Second, some elderly patients must consider the indications for tympanoplasty in the presence of severe physical complications, including severe heart disease and malignant disease. Furthermore, we sometimes encounter the only-or better-hearing ear (2,3). To reduce hesitation to undergo tympanoplasty to improve ear problems, evaluation of postoperative benefits and problems, including bone conduction threshold changes, is very useful and necessary.…”

Evolving Considerations in the Surgical Management of Cholesteatoma in the Only Hearing Ear

“…Sanna and colleagues reviewed 28 cases of cholesteatoma surgery in the only hearing ear accrued from 2 separate tertiary otologic referral centers (24). Sanna and colleagues reviewed 28 cases of cholesteatoma surgery in the only hearing ear accrued from 2 separate tertiary otologic referral centers (24).…”