The experience of the tympanoplasty in Volyn region

Abstract

Introduction: In Volyn middle ear microsurgical interventions were first performed in the early 60s in the previous century. Stapedioplasty, different types of myringoplasty and cholesteatoma middle ear surgery were introduced in the mid 70s. In 1983 a drill as a replacement to a chisel and a mallet, which were traditionally used to perform the bone stage of the ear surgery in the USSR, was introduced by Shchuruk Z.S. Aim: to share the experience of the development of otosurgery in Volyn and the results of the middle ear microsurgery operations in the Department of Otolaryngology in Volyn regional clinical hospital. Materials and methods: For the last twenty years (from 1999 to 2019) 1008 middle ear surgeries which can be divided into three main types: canal-wall-down tympanoplasty – 608 operations, canal-wall-up tympanoplasty – 94 ones and 306 myringoplasty were performed in the Department of Otolaryngology in Volyn regional clinical hospital. In addition, 35 mastoidectomies for acute and latent mastoiditis, 33 extended mastoidectomies with otogenic intracranial complications, 27 extended radical surgeries with otogenic intracranial complications and 560 tympanostomy tube insertion procedure were performed. Results: Complete elimination of air-bone gap after myringoplasty was observed in 20% of patients, the airbone gap in about 80% of patients was about 8dB. After a canal-wall-down tympanoplasty in the late postoperative period the average air conduction thresholds in 35,4% of the patients was less than 30dB. 92% of our patients had a complete wound healing and a positive morphological result in the early postoperative period after different types of tympanoplasty. Conclusions 1. Having evaluated the results of microsurgery operations for the last 20 years (1008 operations), we noted the high rate of positive clinical and functional outcomes. 2. The experience of Volyn otolaryngologists who began to perform middle ear surgeries in the 60-70s of the previous century was transferred to younger generation of otolaryngologists. 3. The performance of tympanoplasty demands in-depth knowledge of the anatomy of temporal bone and a burning desire to perform these complicated surgery interventions.