No4-5(2) 2019
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DOI 10.37219/2528-8253-2019-4-38 |
Shevchenko T.O., Srebniak I.A., Pedachenko A.E., Dzus V.T.
Middle ear surgery functional results in patients with tympanosclerosis
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Shevchenko Tetiana Oleksandrivna
State Institution “Institute of otolaryngology named after Prof. O.S.
Kolomiychenko of the National Academy of Medical Sciences of Ukraine”; Kyiv,
Ukraine.
Ear Microsurgery and Otoneurosurgery Department
Junior Researcher
Candidate of Medical Sciences
E-mail: nuha1977@ukr.net
Orchid ID: https://orcid.org/0000-0002-4338-3202
Srebniak Ilona A.
State Institution “Institute of otolaryngology named after Prof. O.S.
Kolomiychenko of the National Academy of Medical Sciences of Ukraine”; Kyiv,
Ukraine.
Ear Microsurgery and Otoneurosurgery Department
Leading Researcher
Doctor of Medical Sciences
E-mail: isribnyak@hotmail.com
Orchid ID: https://orcid.org/0000-0002-297-9415
Pedachenko Anastasia Evgenievna
State Institution “Institute of otolaryngology named after Prof. O.S.
Kolomiychenko of the National Academy of Medical Sciences of Ukraine”; Kyiv,
Ukraine.
Ear Microsurgery and Otoneurosurgery Department
Researcher
Candidate of Medical Sciences
E-mail: apedachenko@ukr.net
Orchid ID: https://orcid.org/0000-0002-1256-0350
Dzhus Vladimir Teodorovich
State Institution “Institute of otolaryngology named after Prof. O.S.
Kolomiychenko of the National Academy of Medical Sciences of Ukraine”; Kyiv,
Ukraine.
Department of Anesthesiology and Intensive Care
Anesthesiologist
E-mail: amtc@kndio.kiev.ua
Orchid ID: https://orcid.org/0000-0002-0471-7266 |
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Abstract
Actuality: Tympanosclerotic changes (TSC) in the middle ear are
common in patients with chronic otitis media. Tympanoplasty or functional
middle ear surgery might be difficult in some cases due to the close contact
of the TSC masses with the tympanic membrane and auditory ossicles and could
lead to its injuries with sensorineural complications. The functional result
of surgery depends on before and postoperative preventive treatment.
Aim: to develop methods of preventive treatment of possible
sensorineural complications in patients with chronic otitis media with
tympanosclerosis and determine their effectiveness.
Materials and methods: 30 patients were examined before and after
surgery with preventive conservative treatment against possible
sensorineural complications. Performance evaluation was carried out in
nearest postop period (within 6 months) and in follow-up (12 and more
months) after surgery. The patients were divided into 2 groups, depending on
the localization of TSC in the middle ear and got a preventive treatment.
Group 1 – patients with TSC in the stapes area got steroid therapy in the
pre-and post-surgery period. Group 2 – patients with ossicles fixation that
got anti-edema, detoxication and vasoactive therapy.
Results and discussion: Functional middle ear surgeries (different
types of tympanoplasty) for patients with chronic middle otitis and
tympanosclerosis were successful. Positive changes from air conductive (AC)
thresholds were registered in all patients. In follow up after preventive
treatment in patients of group 1 with I stage of conductive hearing loss was
improvement of tonal hearing with decreasing of AC thresholds (16,4±0,6) dB
in comparison with before surgery data. At patients with II stage of hearing
loss the bone conduction (BC) thresholds of tonal air signals reliable
decreased on (25,1±1,4) dB. Patients of 2 group with I stage of hearing loss
in followup got reliable increase of AC (17,3 ±0,9) dB. In patients with III
stage of hearing loss thresholds of BC thresholds
were decrease on (26,5±1,6) dB. In totally we got in all patients hearing
improvement. However, our study found out that surgery treatment that is at
the same time factor which may cause sensorineural complications at these
patients. Proposed preventive treatment which carried out before, intra- and
in post-surgery period could lead positive functional results. That may
decrease number of possible sensorineural complications in follow-up.
Conclusion: Proposed preventive treatment which carried out in pre-,
intra- and post-surgery period could be predicted a possible sensorineural
complication of middle ear surgeries in patients with tympanosclerosis and
could lead the positive functional results. Preventive treatment must be
prescribed to all patients with tympanosclerosis to prevent severe
complications (sensorineural hearing loss, vertigo, dizziness) |
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Keywords
chronic otitis media, tympanosclerosis, surgical treatment, sensorineural
complications, treatment. |
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