The Effect of Endoscopic Tympanoplasty on Cochlear Function

Abstract

Objectives The aim of this prospective clinical study was to measure the audiologic outcomes of the patients that underwent endoscopic transcanal cartilage tympanoplasty, and to investigate the effects on cochlear function.Methods Thirty-three patients (33 ears) who were diagnosed with noncomplicated chronic otitis media and underwent endoscopic transcanal cartilage tympanoplasty technique were included. Pre- and postoperative first month distortion product otoacoustic emission (DPOAE) signal-to-noise ratio (SNR), bone conduction hearing levels and air bone gap (ABG) values were measured and total endoscope usage time was noted.Results Preoperative median SNR measurements at 0.5, 1, 2, and 4 kHz were 6 dB (1–11; interquartile range [IQR], 1), 6 dB (4–20; IQR, 1), 7 dB (3–26; IQR, 5) and 5.50 dB (0–9; IQR, 3), respectively. Postoperative median SNR measurements at 0.5, 1, 2, and 4 kHz were 6 dB (3–9; IQR, 1), 6 dB (2–21; IQR, 3), 7 dB (2–20; IQR, 3), and 6 dB (0–10; IQR, 7), respectively. Regarding the DPOAE measurements, there was no statistically significant difference between the SNR values of all given frequencies (P>0.05). Regarding the pure tone audiometry (PTA) measurements, bone conduction was significantly better at 0.5 and 1 kHz, postoperatively (P<0.05) and there was statistically significant difference at 2 and 4 kHz (P>0.05). Additionally, no statistically significant correlation was found between the SNR and PTA measurements and the endoscope usage time (P>0.05).Conclusion We suggested that cochlear functions and sensorineural hearing remained stable after endoscopic transcanal cartilage tympanoplasty and cold light source doesn’t cause significant adverse effects cochlear functions.

Results of endoscopic transcanal tympanoplasty performed by a young surgeon in a secondary hospital

“… 13 At the same time, the risk of traumatic mechanical damage due to the use of the endoscope during operation and the thermal effect of the xenon light source can be mentioned. Kaya et al 14 stated that cochlear functions stabilized after endoscopic transcanal tympanoplasty with a cold light source. Kozin et al 15 recommended decreasing the light intensity, changing the position of the endoscope frequently, and removing the endoscope to allow tissue cooling.…”

Frequency-Specific Analysis of Hearing Outcomes after Surgery for Chronic Ear Diseases

“…Excessive ossicular chain movement, vibration or noise from drilling, or other inner ear disruption are all associated with high-frequency sensorineural hearing loss (e.g. strong suction or thermal damage) 10 . Generally, canal wall-down tympanoplasty has more drilling time in the middle ear near the stapes and oval window, and the BC seems to be more susceptible to its adverse effect at 4000 Hz.…”