S229 – One-Stage Tympanoplasty with or without Mastoid Obliteration

Abstract

Objectives To confirm the efficacy of one-stage tympanoplasty with mastoid obliteration and a tymapanoplasty by transcanal approach using ceramic prosthesis. Methods Our surgical procedure was performed on 163 patients with cholesteatoma and 545 patients with chronic otitis media in Shinkawa Clinic. The operative method was classified into 2 groups. We use one-stage tympanoplasty with mastoid obliteration, a canal wall down procedure for chronic otitis media with cholesteatoma and chronic otomastoiditis. On the other hand, we use a tympanoplasty by an endaural approach for chronic otitis media without chronic otomastoiditis. The ossicular chain was reconstructed using the ceramic ossicular prosthesis (P-type and T-type). We performed modified Type III tympanoplasty using the P-type ceramic when the superstructure of the stapes could be utilized, while we performed modified Type IV tympanoplasty using the T-type ceramic when the superstructure of the stapes could not be used. Results In chronic otitis media with cholesteatoma or chronic otomastoiditis, the success rate of modified Type III tympanoplasty using ceramic P type was 77.8%; on the contrary, that of modified Type IV tympanoplasty using ceramic T type was 70.6%. In chronic otitis media without chronic otomastoiditis, the success rate of modified Type III tympanoplasty using ceramic P-Type was 69.8%, while that of modified Type IV tympanoplasty using ceramic T was 69.1%. Conclusions Our results show that there are no significant differences of success rate between these 2 procedures. We confirmed that the use of ceramic implant was satisfactory for both one-stage tympanoplasty with mastoid obliteration and a tympanoplasty by an endaural approach.