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Revista de otorrinolaringología y cirugía de cabeza y cuello

versión On-line ISSN 0718-4816

Resumen

CORTEZ V, Pedro; RUBIO M, Fabián  y  STOTT C, Carlos. Hearing influence of the posterior ear canal wall, in the conductive hearing loss after tympanomastoidectomy. Rev. Otorrinolaringol. Cir. Cabeza Cuello [online]. 2018, vol.78, n.4, pp.378-384. ISSN 0718-4816.  http://dx.doi.org/10.4067/s0717-75262018000400378.

Introduction:

Cholesteatomas treatment is surgical and the goals are complete resection of it, to prevent complications and recurrences. The gold standard operative technique is canal wall down tympanomastoidectomy (CWDT), which reduces the recurrence rate lower than 2%. Studies on human temporal bones have defined that CWDT causes a decrease of 1 to 5 dB at frequencies below 1000 Hz and 0 to 10 dB between 1000 and 3000 Hz.

Aim:

To determine how many decibels the hearing is improved by reconstituting the posterior wall of the ear canal (EC) in patients after CWDT.

Material and method:

Experimental study. In patients after CWDT, the posterior wall of EC was reconstructed temporarily. Audiometry was performed before and after the procedure.

Results:

23 patients were enrolled (25 ears evaluated). Average age 48.8 years (range 18 to 72 years). In 96% of the ears there was a difference after the procedure with a hearing improvement of 4.2 ± 2.8dB. In frequencies below 1000 Hz, hearing improvement was 6.0 dB (p<0.001), between 1000-3000 Hz, the improvement was 2.6 dB (p<0.001) and >3000 Hz there was no difference. When considering the airway-conduction pure tone average (PTA), the difference was a 4.6 dB improvement (p<0.001).

Conclusions:

Our study shows that there is a hearing improvement in the vast majority of ears that were evaluated by reconstituting the posterior wall of the EC, reaching a gain of 6 dB at frequencies <1000 Hz and 2,6 dB at mid frequencies. Considering the airway PTA, the improvement is 4.6 dB in the presence of posterior canal wall.

Palabras clave : Cholesteatoma; tympanomastoidectomy; hearing improvement; ear canal.

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