Hearing Results after Tympanoplasty in Elderly Patients with Middle Ear Cholesteatoma

• Published in: Acta oto-laryngologica Vol. 121; no. 8; pp. 919 - 924
• Main Author: Nomura, Yukiko Iino, Hideki Hashimoto, Jun-Ichi Suzuki, Kazuoki Kodera, Kyoko
• Format: Journal Article
• Language: English
• Published: Stockholm Informa UK Ltd 01.01.2001; Taylor & Francis; Taylor and Francis
• Subjects: Adult; Aging Canal Wall Reconstruction Tympanoplasty Postoperative Hearing Level Sensorineural Hearing Loss; Audiometry, Pure-Tone - methods; Biological and medical sciences; Bone Conduction - physiology; Cholesteatoma, Middle Ear - surgery; Cohort Studies; Ear Canal - surgery; Ear, auditive nerve, cochleovestibular tract, facial nerve: diseases, semeiology; Female; Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics; Hearing Loss, Sensorineural - diagnosis; Humans; Male; Medical sciences; Middle Aged; Otorhinolaryngology. Stomatology; Postoperative Period; Reconstructive Surgical Procedures - methods; Retrospective Studies; Severity of Illness Index; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the ear, the auditive nerve and the facial nerve; Tumors; Tympanoplasty - methods; Human; Reconstruction; Prognosis; Middle ear disease; Plastic surgery; Retrospective; Result; Hearing; Treatment; Cholesteatoma; Exeresis; Tympanoplasty; Surgery; Cohort study; ENT disease; Tumor; Middle ear; Auditory canal; Elderly
• ISSN: 0001-6489; 1651-2251
• DOI: 10.1080/00016480127374

Many reports about the effect of aging on hearing results after tympanoplasty have been published. However, they have not been evaluated comprehensively, i.e. by taking into consideration other aspects which also affect the outcome. In this study, the effect of aging on hearing results after canal wall reconstruction tympanoplasty was assessed in 236 consecutive ears of 213 patients > 20 years old with middle ear cholesteatoma. The elderly group ( n = 34), defined as patients &#83 60 years old, was compared to the younger groups in terms of hearing results of postoperative hearing level, hearing gain, A-B gap and change in bone conduction hearing level at 4000 Hz after adjustment for age, gender, staged operation, preoperative hearing level and type of tympanoplasty, all of which affect hearing results, using the generalized linear regression method. Postoperative hearing level and hearing gain were found to be better amongst patients aged 20-29 and 30-39 years than in the elderly group, whilst A-B gap did not differ between all age categories. Within the elderly group, air conduction hearing level was shown to have improved after surgery. Changes in bone conduction hearing level at 4000 Hz were not significantly different between the age groups, suggesting that operative stress, i.e. mechanical stress or ossicular manipulation stress, does not aggravate sensorineural hearing loss in the elderly. We conclude that surgeons should be encouraged to perform tympanoplasty aimed not only at eradicating the lesion itself but also at improving should be encouraged to perform hearing acuity in the elderly.