The epidemiology of tympanosclerosis in chronic otitis media patients in the Kars region of Turkey: The role of computerized temporal tomography in diagnosis of tympanosclerosis

Abstract

The aim of this study was to evaluate tympanosclerosis patients operated with tympanoplasty in terms of patient profile, clinical characteristics, diagnostic role of preoperative computed tomography (CT) and postoperative graft and hearing outcome. The patients operated with tympanoplasty due to tympanosclerosis were included in this study. Data on patient demographics, type of otitis media, preoperative findings, characteristics of tympanosclerosis, preoperative temporal bone CT findings and preoperative and post-operative audiological assessment were recorded in each patient. Postoperative hearing outcome (pure tone averages, air-bone gap) and graft survival rates were also recorded. Most of patients with operated tympanosclerosis were females (75.9%) and in the 41-60 year (37.0%) age group. CSOM (81.5%) was the most common diagnosis. Tympanosclerosis was open type in 94.0% and located in posterioinferior tympanic membrane in 35.2% of patients and in epitympanum of middle ear in 53.7% of patients with involvement of malleus and incus in most of cases. Loss of mastoid air and volume (94.4%) and high-density areas in middle ear and around ossicles (88.9%) were the leading findings on pre-operative temporal bone CT. Overall graft survival rate was 75.5%, and higher with cartilage than temporal fascia grafts. A significant improvement was noted in pure tone average and air-bone gap (p=0.000). Preoperative temporal bone CT findings seem to offer a potential pre-surgical guide for surgeons operating tympanosclerosis. Tympanoplasty was associated with favorable graft outcome, particularly for cartilage rather than temporal fascia grafts and improved postoperative hearing outcome in terms of pure tone averages and air-bone gap, regardless of the graft type.