To Observe The Clinical Efficacy Of Modified Canal Wall Up Tympanoplasty

ObjectiveTo explore the efficacy of modified canal wall up tympanoplasty for chronic suppurativeotitis media and chronic otitis media with cholesteatoma.Methods50patients (50ears) with chronic suppurative otitis media and chronic otitis media withcholesteatoma were diagnosised in the First Affiliated Hospital of Jinan UniversitJinan from2008to2010.They were allotted to two groups of25each. Patients in group A underwent modifiedcanal wall up tympanoplasty without mastoidectomy and those in group B underwent canal wallup tympanumastoidectomy with mastoidectomy.All the patients were followed up0.5to2.0years. To compare with each group’s air conduction and air-bone gap between preoperative andpostoperative. To compare with two group’s the change in air conduction and the change inair-bone between modified canal wall up tympanoplasty and canal wall up tympanumastoidect-omy.results were assessed in hearing improvement,successful rate and recurrence rate,analyzesand discusses the characteristics of modified canal wall up tympanoplasty in microsurgery.ResultsThe mean postoperative air conduction of the patients underwent modified canal wall uptympanoplasty of was18.978±4.032dB and air-bone was7.938±2.613dB(P are respectivelyequal to0.000and0.000), the significant difference in the modified canal wall uptympanoplasty of preoperative pure-tone audiometry results between postoperative. Canal wallup tympanomastoidectomy of mean postoperative air conduction was21.684±5.235dB andair-bone was9.444±4.301dB(P are respectively equal to0.000and0.000), the significantdifference in canal wall up tympanomastoidectomy of preoperative pure-tonpe audiometryresults between postoperative. The modified canal wall up tympanoplasty of mean change inair conduction was24.694±4.759dB and the canal wall up tympanomastoidectomy was19.708±3.893dB. The modified canal wall up tympanoplasty of mean change in air-bone was21.702±4.180dB and the canal wall up tympanomastoidectomy was18.300±3.487dB.(P are respectively equal to0.000and0.030), the efficiency was significant difference in themodified canal wall up tympanoplasty between canal wall up tympanomastoidectomy. Thepostoperative hearing threshold level improved by10～19dB(average air conductionthreshold) in3ears(12%), by20～30dB in18ears (72%), by more than30dB in4ears(16%)and the mean air bone gap (ABG) of19ears was reduced to less than20dB(76%).After operation, all the patients kept integrity tympanic membrane and have not pocketretraction. The recurrence rate was0%. dry ear for an average of2.5to4.0weeks.ConclusionsModified canal wall up tympanoplasty maintains the air exchange pathway and theeffective volume of middle ear to mastoid. The results of the operation are satisfied with littlewound and good cured effect.