Abstract

Postoperative hearing improvement is one of the main expectations for patients receiving tympanoplasty. The capacity to predict postoperative hearing may help to counsel a patient properly and avoid untoward expectations. It is difficult to predict postoperative hearing without knowing the disease process in the middle ear, which can only be assessed intraoperatively. However, the duration and extent of the underlying pathologies may represent in bone-conduction threshold and air-bone gap. Here in patients undergoing tympanoplasty without ossiculoplasty, we sorted and separated the surgery dates into the first group to build the predicting models and the second group to test the predictions. There were 87 and 30 ears, respectively. No specific enrollment or exclusion criteria were based on underlying pathologies such as the perforation size of the tympanic membrane or the middle ear conditions. The results show that bone-conduction threshold and air-bone gap together predicted air-conduction threshold after the surgery, including each frequency of 0.5k, 1k, 2k, and 4k Hz. The discrepancies between the predictions and recordings did not differ among these four frequencies. Of the variance in mean postoperative air-conduction threshold, 56.7% was linearly accounted for by these two preoperative predictors in this sample. The results suggest a trend that, the higher the frequency, the larger the part was accounted for by these two preoperative predictors. These together may help a surgeon to estimate frequency-specific hearing outcome after the surgery, answer patients’ questions with quantitative statistics, and counsel patients with proper expectations.

Highlights

  • Impaired hearing is one of the main presentations in patients with chronic otitis media (COM) [1, 2], which is the main indication of tympanoplasty

  • Improving hearing is one goal of tympanoplasty [3,4,5], in addition to removing the underlying disease [5] and producing a safe dry ear [5]. It would be helpful if ear surgeons can predict the outcome of postoperative hearing and give proper counseling for the patient, to avoid untoward expectations [6]

  • There were no specific enrollment or exclusion criteria based on underlying pathologies such as the perforation size of the tympanic membrane or the middle ear conditions

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Summary

Introduction

Impaired hearing is one of the main presentations in patients with chronic otitis media (COM) [1, 2], which is the main indication of tympanoplasty. Improving hearing is one goal of tympanoplasty [3,4,5], in addition to removing the underlying disease [5] and producing a safe dry ear [5]. It would be helpful if ear surgeons can predict the outcome of postoperative hearing and give proper counseling for the patient, to avoid untoward expectations [6]. The capacity of predicting postoperative hearing may avoid indecent expectations and enable ear surgeons to estimate other acoustic or psychometric benefits before a tympanoplasty. The magnitude of improvement in the air-conduction threshold after the surgery reportedly plays a more important role on psychometric benefit than the achievement of a certain threshold level [7]

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