| IntroductionThe first myringoplasty was performed by Marcus Bancer in 1640, tympanoplasty has developed more than fifty years. Many factors , medical and non - medical, influence the selection of tympanoplasty. The indication for tympanoplasty has become broad. Otorrhea or otopyorrhea may not be forbidden for tympanoplasty in clinical practice. Preoperative infection, especially resistant bacteria is one of the problems that surgeon consider, it is difficult for surgeon to select sensitive antibiotic after operation.Whether do the broad of indication, the infection of bacteria and the selection of systemic antibiotics influence the outcome of tympanoplasty? In order to answer some of these questions we performed a retrospective study Surveying 174 cases of tympanoplasties in the first clinical hospital of china medical university during a four - year period from Jun 1996 to Jun 2000.Materials and MethodsDuring the Four - year period Jun 1996 through Jun 2000 in thefirst clinical hospital of china medical university, 174 cases of tymp -anoplasties was surveyed. Aged from 7to 70 years, with a mean of 34. 7 years. Men 9, women 67. Operation included Wullstein -type I , III,IV, of this total, 61 were type - I , 72 were type -III, 41 were type-IV, and open method tympanoplasties were 75 cases. This series of type - I tympaneplasties did not include procedures in which a mastoidectomy was performed. And the patients who were younger than 14 years, type-II were not included, and patients with diabetes or immunodeficiency were excluded. All of the tympanoplasties was carried out by a surgeon.Operative technique: Most of the patients were operated on with local anesthetic, but those who requested it or too young received general anesthesia. Grafting material of tympanic membrane used was temporal fascia which was taken through a postauricular approach, u-sing the under-lay technique or in-lay technique .Cholesteatoma otitis media: Open method tympanoplasties were operated on with a postauricular incision. After temporal fascia was taken. A U - shaped flag was made with the skin subcutaneous tissue and the mastoid periosteum and the broken bits of normal mastoid process coxtex were made. then performed mastoidectomy. In either case, the middle ear space should be carefully evaluated, especially, the tympanic part of the ET was always inspected, and if found to be blocked by scar tissue or thickened mucosa the mucosa was removed. Mastoid cavity plombaged with homological costal cartilage, U -shaped periosteum connective tissue valve and mastoid process coxtex. For ossicular chain reconstruction we used homological costal cartilage. All of tympanoplasties used glue and received systemic antibiotics for 7days after operation.Follow up took place at one - week interval for two visits and then at longer intervals as needed. The follow - up period was at least six months. When at least six months of follow - up information was not a-vailable, the case was not included in this study. The criteria of surgical success: 1. An intact tympanic membrane and an dry ear . 2 hearing improvement: based on the mean of hearing threshold of 500HZ, 1KHZ, 2KHZ; (1) air conduction improved at least 15 dB; (2)air -bone gap was less than 20 dB; (3) Hearing threshold of air conduction was less than 40 dB. If achieved one of the conditions we considered hearing improvement, otherwise, it is no change or failure. We examined hearing at the first, third and sixth months after operation, and based on the hearing of the sixth months.The charts of the patients were reviewed: age, size and site of perforation, preoperative and postoperative audiometric results, preop-erative otorrhea, preoperative bacteria training test and the drug sensitivity test, operative technique, the days of wound healing and the postoperative days in hospital, the postoperative days till dry - ear.The results were statistically analyzed by the chi - square test and t - test.ResultsA total of 174 tympanoplastie...
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