Tympanoplasty in Chronic Adhesive Otitis Media

Abstract

The results of tympanoplasty on 56 patients with chronic adhesive otitis media are presented. the principle of the method was radical removal of the diseased parts of the drum, preservation of the mucosa, inspection and opening of the tubal orifice with bougienage of the tube, mobilization of the ossicles, ossiculoplasties increasing the height of the tympanic cavity, insertion of silastic film around the stapes, and tubulation. the mean hearing gain in the frequency range 500-2 000 cps 3-9 months after the operation was 23.5 dB, postoperative hearing 35 dB and air-bone gap 15.6 dB. in 80% of the cases the tympanoplasty proved successful, and 86% of the patients obtained a hearing gain exceeding 10 dB. the most favourable results were observed in cases tubulated at the time of the tympanoplasty. the results are analysed in relation to tubal passage, assessed by the Valsalva manoeuvre before and after the operation. the best results were obtained when the tube was passable before and after the operation in the Valsalva manoeuvre, poorest when it was not passable either before or after the operation.