Tympanoplasty results in an ethnically diverse patient population

Objectives: To examine and report results for tympanoplasties performed in a tertiary-care city teaching hospital serving one of the most ethnically diverse neighborhoods in the United States. Study Design: Retrospective chart review. Methods: Adult patients who underwent type I tympanoplasty from January 2009 through July 2010 were eligible. Charts were reviewed for preand postoperative drum status, patient characteristics, temporal bone CT scans and audiologic data. The primary outcome measure was successful repair, defined as an intact drum at last follow-up visit. A secondary outcome measure was postoperative hearing improvement, defined as a difference between airconduction and bone-conduction pure-tone averages of less than 20 dB. Results: 27 patients were included in the study. 15 patients (64%) had perforations greater than 50% of the drum area and 10 (37%) had bilateral perforations. 18 patients (67%) had a successful repair. Success rates were lower in patients with preoperative temporal bone CT scans showing chronic otomastoiditis compared to those with normal CT scans (p< 0.0034); perforation size, patient age, bilateral disease and ethnicity were not predictive factors. 13 patients with successful repairs had postoperative audiograms performed and 11 (85%) showed hearing improvement. Conclusions: Ethnically diverse patient populations found at a city teaching hospital may be more difficult to treat because of a higher incidence of active chronic otitis media with perforations. Meticulous surgical technique with close attending surgeon-resident supervision, review of preoperative CT imaging and evaluation for aerating mastoidectomy may lead to improved success for tympanoplasty in this population.

Duke Scholars

Author Jeffrey Cheng Pediatric Otolaryngology