Objective:To analyze the clinical effect of 54 cases with chronic otitis media prepared for staging tympanoplasty and 19 cases finished staging ossicular reconstruction surgery, evaluate the advantages of different surgery technique.Method:Fifty-four cases with chronic otitis media were planned for staging tympanoplasty surgery and had been received the first stage surgery. Silicagel plates were placed in the tympanic cavity in order to prevent adhesions. Among them, 19 cases had received the second stage ossicular reconstruction, including 10 cases with TORPs and 9 cases with PORPs. The average air bone gaps (ABG) were measured at four frequencies: 500, 1 000, 2 000 and 4 000 Hz.Result:Among the 54 cases, 45 cases had swollen mucosa in the tympanic cavity and eustachian tube, 18 cases had tympanic fibrous adhesions, and 12 cases had fixed or sclerotic stapes. The preoperative ABG of the 54 cases were (38.26±7.88)dB. As for the 19 cases finished the second stage surgery, their preoperative ABG in the first stage were (39.21±7.05)dB, the preoperative ABG in the second stage were (38.82±11.43)dB, and the postoperative ABG after the second stage were (21.77±11.92)dB. The hearing function after staging tympanoplasty was significantly improved compared with the preoperative hearing in the first and the second stage operation (P< 0.01). In addition, the second stage surgery of three cases was postponed because of a good postoperative hearing with (10.42±10.63)dB ABG after the first stage surgery. Up to now, none of the 54 cases suffered from facial palsy, infection and other complications after surgery.Conclusion:Staging tympanoplasty is an important technique to improving hearing and reducing the complications, especially for the cases with chronic otitis media unsuitable for one stage reconstruction of ossicular chain.
Keywords: ossicular chain reconstruction; otitis media,suppurative; tympanoplasty.
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