Comparison of postoperative odiologic results of mobilization and incus interposition techniques in limited tympanosclerosis
Hasan Deniz Tansuker1, Erdal Sakallı2, Cengiz Çelikyurt2, Sultan Bişkin3, Firuzan Köktürk4, Burak Güler2
1Devrek Devlet Hastanesi, Zonguldak, Türkiye
2Özel Bağcılar Safa Hastanesi, Istanbul, Türkiye
3Bülent Ecevit Üniversitesi Tıp Fakültesi, Kulak Burun Boğaz Ve Baş Boyun Cerrahisi Kliniği, Zonguldak, Türkiye
4Bülent Ecevit Üniversitesi Tıp Fakültesi, Biyoistatistik Anabilim Dalı, Zonguldak, Türkiye
Keywords: Incus interposition, mobilization, tympanosclerosis.
Abstract
OBJECTIVE: This study aims to compare together with the literature the odiologic results of patients who underwent either ossicular chain mobilization or incus interpositioning due to tympanosclerosis associated hearing loss.
METHODS: Files of 25 patients who were operated due to tympanosclerosis between October 2010 and October 2013 were retrospectively reviewed. Revision patients, patients with cholesteatoma, patients having history of middle ear surgery, patients with stapes fixation, and patients having only myringosclerosis were excluded. Thirteen patients whose ossicular chain mobilization was provided by cleaning of tympanosclerotic plaques were identified as group 1, and 12 patients who were performed incus interpositioning were identified as group 2. Odiologic results at postoperative sixth month were used for evaluation. A postoperative air-bone gap value of less than 20 dB, or 10 dB and more improvement in air conduction were regarded as success criteria.
RESULTS: In group 1, mean air conduction threshold decreased from preoperative 59.69±14.34 dB to postoperative 37.31±18.51 dB, and this was statistically significant (p=0.001). Mean air-bone gap value decreased from preoperative 43.69±10.76 dB to postoperative 24.00±11.51 dB, and this was also statistically significant (p=0.001). In the second group, mean air conduction threshold decreased from preoperative 50.83±8.97 dB to postoperative 32.92±10.26 dB, and this was statistically significant (p=0.001). Mean air-bone gap value decreased from preoperative 37.92±7.07 dB to postoperative 23.50±7.47 dB, and this was also statistically significant (p=0.001). In both groups, postoperative air-bone gap values decreased below 20 dB in nine patients. According to this, success rates were 69.2% and 75% in group 1 and group 2, respectively. However, no statistically significant difference was detected between the success rates of the groups (p=0.211).
CONCLUSION: Ossicle mobilization and incus interpositioning are two efficient surgical procedures in tympanosclerosis patients with adequate indications, and they have no superiority against each other in terms of postoperative odiologic results.