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A comparison of the effects between different tympanoplasty techniques for cholesteatoma

Objective To compare the efects between different tympanoplasty techniques for chdesteatoma. Methods 38 cases(ears) who were operated on between Jan., 2002 and Apr., 2003 were served as group A(25 male , 13 female ; age: 13-72 years). They had been followed up for 12-28 months postoperatively, with an average of 18.56 months. Of the 38cases, 6 have had a relapse after an operation performed in our or other hospitals 1-6 years ago. Other 38 cases (40 ears) who were operated on between Apr., 1995 and Dec., 1999 were served as group B(17 male, 21 female; age: 9-60 years). They had been followed up for 6-110 months (mean 17.12 months). Of them, 5 were recurrent cases. The two groups were comparable in the air conduction (AC) and air bone gap (ABG) values , and had no difference statistically. The operative method in group A was based on a combination of verious techniques, including lateral attic wall reconstruction (scute repair), chorda tympani nerve tightening prosthesis, and prevention of adhesion formation by a absobable membrane. In group B, tympanoplasty with modified mastoidectomy was performed. The audiological data obtained from the last follow-up in the two groups were used for statistical analysis (student’s t test). Results The postoperative AC and ABG and the ABG differences between pre-and post-operation in group A were 27.05±12.53, 12.89±8.08 and 22.34±11.92, respectively. The counterparts in group B were 42.76±14.22, 22.27±10.95 and 8.83±8.72, respectively. All the differences between them were statistically significant(P0.01). Group A had re-perforation of the tympanic membrane in 4 cases (10.5%) during the follow-up time. Of them 3 cases received a revision operation and only one ear had cholesteatoma remnants(2.6%). In Gyoup B, however, there were 9 cases(22.5%) who received a revision operation for recurrent cholesteatoma. Conclusion A combination of various operation procedures for cholesteatoma adopted in this study had evident advantages in prevent of recurrent cholesteatoma and improvement of hearing outcome.