Prognostic roles of preoperative CT findings and air-bone gaps in type 1 tympanoplasty

Abstract

Background: Although CT has been used widely, the role of preoperative CT findings including other factors in tympanoplasty has not been elucidated comprehensively.

Aims/objectives: To evaluate relationship of CT findings with other factors and audiological results in type 1 tympanoplasty.

Material and methods: A cohort of consecutive 175 patients with type 1 tympanoplasty was enrolled. Addition of mastoidectomy was based on the presence of soft tissue in antrum on CT. Postoperative air–bone gap (ABG) and reperforation rate were analyzed.

Results: Positive soft tissue in antrum on CT was found in 52 (29.7%) patients and showed larger preoperative ABG than the negative group. Successful ABG closure (≤20 dB) was obtained in 97% when preoperative ABG ≤20 dB, but it decreased as the preoperative ABG increased (83% with preoperative ABG of 21–30 dB, and 0% with preoperative ABG >30 dB). Postoperative reperforation rate was positively related to the preoperative ABG, but not the presence of soft tissue in the antrum, the size, or locations of preoperative perforations.

Conclusions and significance: Our findings showed that temporal bone CT was helpful in determining addition of mastoidectomy and the presence of soft tissue in the antrum was associated with large ABG.

Chinese abstract

背景：虽然CT已被广泛应用, 但对包括鼓室成形术中其他因素的术前CT检查结果的作用尚未解释清楚。

目的：评估带其他因素的CT结果与1型鼓室成形术的听力结果之间的关系。

材料和方法：纳入连续的175例1型鼓室成形术患者。依据CT检查中窦内软组织的存在来增做乳突切除术。分析术后气骨间隙（ABG）和再穿孔率。

结果：52例（29.7％）患者CT显示窦腔阳性软组织, 术前ABG较阴性组大。术前ABG ≤20 dB时, 97％获得成功的ABG闭合（≤20 dB）, 但它随着术前ABG增加而减少（术前ABG为21-30 dB时为83％, 术前ABG> 30 dB时为0％） 。术后再穿孔率与术前ABG呈正相关, 但与窦内软组织的存在、术前穿孔的大小或位置无关。

结论和意义：我们的研究结果表明, 颞骨CT有助于确定是否加做乳突切除；窦内软组织的存在与大的ABG相关。

Keywords:

• Tympanoplasty
• tympanomastoidectomy
• myringoplasty
• air–bone gap
• perforation
• chronic otitis media
• middle ear surgery

Disclosure statement

No potential conflict of interest was reported by the authors.