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Author:
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N.B. Prahlada, Karnataka ENT Institute & Research Centr, Chitradurga, India |
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Co-author(s):
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Topic:
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Results |
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Keywords:
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Tympanosclerosis, Stapes mobilization, Clinical Predictors, Anterior tympanotomy |
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OBJECTIVES: Clinically significant tympanosclerosis is one which requires a surgical procedure to effect a hearing improvement. Tympanosclerosis is found in more than 30% of patients with chronic ear disease and more than half of them may have clinically significant tympanosclerosis. .It is often difficult to preoperatively predict the extent of tympanosclerosis, required type and number of surgical procedures and probable outcome of the surgery. Our experience of tympanosclerosis surgery guided by various prognostic clinical predictors are presented here.
METHODS: In this randomized prospective study conducted from Dec’1996 to till today, 236 patients with tympanosclerosis were observed. Mean observation time was 1.9 years, with a follow up rate of 91%. Patients were grouped into four groups such as favorable, moderate, severe and risky, depending on various clinical-audiological findings. Excision of tympanosclerosis plaques, Anterior tympanotomy or Transmeatal atticotomy with ossicular mobilization, and Second stage ossicular mobilization surgery depending on the prognostic clinical predictor group.
RESULTS : The best results are obtained in cases when only excision of the tympanosclerotic plaques and tympanoplasty was required. Moderate results were obtained in cases where anterior tympanotomy or wide atticotomy and mobilization of the ossicular chain or ossicular reconstruction were required. Results were poor in cases where stapes mobilization or stapedectomy was required.
CONCLUSIONS : This study indicates that tympanosclerosis is amenable to surgical correction and prognostic clinical predictors help in determining the appropriate surgery.
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