The Clinical Research Of Stage â…  Ossicular Chain Reconstruction With Ossicular Replacement Prosthesis In The Middle Ear Cholesteatoma

Objective:To investigate the application of titanium ossicular prostheses in the middle ear cholesteatoma operation, and observe postoperative hearing results and analysis the related influencing factors.Methods:This paper study the clinical curtive effects of 60 patients(60 ears) with middle ear cholesteatoma in our department from October 2014 to October 2014, all the data of follow-up cases are complete. Experimental group of 30 ears who underwent mastoidectomy with tympanoplasty, and control group of 30 ears who underwent radical mastoidectomy. Compared two groups duration of dry ear and subjective hearing test results. The experimental group of 18 ears who underwent canal wall down tympanoplasty, and 12 ears who underwent canal wall up tympanoplasty, To compare with air conduction hearing threshold and air-bone gap between preoperative and postoperative of two kinds of operation method. Using Fisher exact probability method analysis the factors which include age of patients, course of disease, eustachian tube function, stapes situation and tympanic mucosa situation that may influence the postoperative efficacy.Results:There was no significant difference in age, gender,course of disease and audiological tests of preoperative between experimental group and control group(p< 0.05). The average duration of dry ear after operation experimental group was 6.0±1.6 weeks, control group was 6.3±1.2 weeks, there was not considered statistically significant between two groups. The average duration of dry ear who underwent canal wall down tympanoplasty was 6.2±1.4 weeks, who underwent canal wall down tympanoplasty was 4.6±1.3weeks, there was considered statistically significant between two kinds of operation method (p<0.05). The experimental group △AC was 18.33±9.89dB, AABG was 8.7±7.15dB, control group AAC was-11.20±10.88dB, AABG was 1.86±8.11dB,there was considered statistically significant in AAC and AABG between the two groups(p<0.05). The group who underwent canal wall down tympanoplasty AAC was 18.94±10.00dB, AABG was 9.72±6.56dB,who underwent canal wall down tympanoplasty AAC was 17.41±10.07dB,AABG was 7.16±8.00dB, there was considered statistically significant in AAC and AABG between two kinds of operation method (p<0.05).Fisher exact probability method analysis indicates that course of disease, the eustachian tube function, stapes situation and tympanic mucosa situation was main factors that influence the postoperative efficacy.Conclusions:1. Rational use of titanium ossicular prostheses in tympanoplasty for middle ear cholesteatoma, can well recovery and protection postoperative hearing, and shall not affect the average duration of dry ear, and obviously improve life quality of the patients.2. Hearing improvement has no significant difference between canal wall down tympanoplasty with canal wall up tympanoplasty, the latter duration of dry ear shorter.3. Many factors affecting the curative effect of tympanoplasty, the course of disease, eustachian tube function, stapes situation and tympanic mucosa situation was main factors that influence the postoperative efficacy.