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Clinical Characteristics and Surgical Benefits and Problems of Chronic Otitis Media and Middle Ear Cholesteatoma in Elderly Patients Older Than 70 Years

Shinnabe, Akihiro; Hara, Mariko; Hasegawa, Masayo; Matsuzawa, Shingo; Kanazawa, Hiromi; Yoshida, Naohiro; Iino, Yukiko

doi: 10.1097/MAO.0b013e31825f24ba
Middle Ear and Mastoid Disease
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Objective To investigate the benefits and problems of tympanoplasty in elderly patients older than 70 years.

Study Design Retrospective case review.

Setting Referral hospital otolaryngology department.

Patients Among 1,014 patients who underwent tympanoplasty for chronic otitis media from 2006 to 2011, those aged over 70 years were eligible for inclusion.

Main Outcome Measures Clinical characteristics including tympanosclerosis and preoperative severe complications were investigated. In chronic otitis media group, hearing outcomes (air-bone gap at 500-Hz and 1- and 2-kHz frequency) and postoperative ear condition were investigated. In chronic otitis media with cholesteatoma, clinical characteristics including postoperative bone conduction hearing threshold (at 500-Hz and 1- and 2-kHz frequency) were investigated.

Results Ninety-seven ears of 83 patients were included. Eighteen ears had obvious findings of tympanosclerosis (18/97 = 18.6%). In chronic otitis media without cholesteatoma (52 ears/47 patients), no preoperative complications were noted. The mean air-bone was 30.8 and 16.1 dB before and after the operation, respectively (p < 0.001). Otorrhea disappeared in 51 ears (98.1%). In chronic otitis media with cholesteatoma (42 ears/33 patients), we noted preoperative severe complications including labyrinthine fistula (7/97 = 7.22%), widely exposed dura (1/97 = 1.03%), and facial palsy 1 (1/97 =1.03%). The mean bone conduction hearing threshold was 39.6 dB and 40.89 dB, respectively (p = 0.7). Three ears of 3 patients had operated ears with open mastoid and underwent canal wall reconstruction tympanoplasty.

Conclusion Tympanoplasty in elderly patients older than 70 years seems to be as safe as when performed in younger patients.

Department of Otolaryngology, Jichi Medical University, Saitama Medical Center, Saitama, Japan

Address correspondence and reprint requests to Akihiro Shinnabe, M.D., Department of Otolaryngology, Jichi Medical University, Saitama Medical Center, 1-847 Amanuma-cho, Omiya-ku, Saitama, Japan 330-8503; E-mail: aknewpan@jichi.ac.jp

The authors disclose no conflict of interest.

© 2012 Otology & Neurotology, Inc.