노인의 만성 중이염에 대한 수술성적

Abstract

Background and Objectives: The number of elderly patients undergoing tympanoplasty is on the increase because of the increasing percentage of the elderly persons in the population, greater anesthetic safety, and greater otosurgical technique. This study was attempted to compare the postoperative results in the elderly and adult patients received tympanoplasty with or without mastoidectomy and to evaluate the prognostic factors related to the postoperative hearing results and complications. Materials and Methods: Retrospective review of the 84 elderly (60 or more year old) and 150 adult (16-59 year old) patients among total of 2,982 patients with chronic otitis media with or without cholesteatoma who were surgically treated at the Department of Otolaryngology, Pusan National University Hospital from January 1996 to December 2003. Results: 1) In the elderly patients, most common hearing loss is the mixed type. 2) Graft success rate is 92.9% and hearing success rate is 47.6%. Graft success rate and hearing success rate were better in good eustachian tube function. 3) The most common concomitant disease is hypertension. Graft and hearing success rate is higher in patients who have no concomitant disease, but there was no statistically significant difference between the elderly and adult groups. 4) Type II tympanoplasty was more frequently performed. The incidences of type II tympanoplasty decreased with age, whereas the type III tympanoplasty slightly increased with age. 5) Hearing success rate is higher in patients performed only tympanoplasty than mastoidectomy with tympanoplasty. 6) There were no severe complications of surgery in the elderly patients. Conclusion: The need for tympanoplasty in the elderly patients is often to correct of conductive hearing loss and to obtain dry ear, which greatly helps in wearing a hearing aid. If the general state of the elderly patients allows operation, middle ear surgery for chronic otitis media should be recommended. (J Clinical Otolaryngol 2005;16:227–234)