[Clinical analysis of tympanoplasty combined with ventilation tube insertion in otitis media].

Objective: The aim of this study is to explore the feasibility and clinical effect of tympanoplasty combined with ventilation tube insertion in otitis media. Method: Retrospective analysis of 35 patients with eustachian tube obstruction or tympanic adhesions for tympanoplasty combined with ventil ation tube insertion in otitis media in EENT Hospital of Fudan University from April 2008 to December 2010. Preoperative routine hearing tests and temporal bone CT examination. Completely remove of lesions at the same time and as much as possible to protect the integrity of the tympanic wall mucosa during operation. Reconstruction of the ossicular chain and simultaneous tympanic membrane hole and placed silicone T-type ventilation tube. All patients were tested for pure tone auditory threshold at 3 months after operation. The patients were followed up for 12 to 44 months. Result: The average hearing level of PTA (0.5,1.0,2.0 kHz) was (31.71±12.25) dBHL. 28 cases (80.0%) had improved to 40 dBHL after operation, 5 cases (14.3%) had hearing enhancement of 10-20 dBHL, and 2 patients (5.7%) had no change in hearing. The number of cases with air bone gap (ABG)(0.5, 1.0, 2.0 kHz) reduced to less than 20 dBHL was 25, 32 and 34 after operation. Ventilation tube self-prolapse in15 cases, 12 cases of artificial removal and 8 cases of inpatient. Twenty seven cases were left perforation of tympanic membrane, of which 22 cases (81.5%) were spontaneously healed and 5 cases(18.5%) were left with small perforations less than 2 mm in diameter. All of them had dry ear after operation, none of them had recurrence after operation, 33 cases (94.3%) had dry ear within 12 weeks, and only 2 cases(5.7%) had dry ear for more than 6 months. Conclusion: Tympanoplasty combined with ventilation tube insertion for the middle ear mucosal dysfunction and eustachian tube mucosal dysfunction of otitis media treatment effect is obvious. It does not extend the dry ear time and cause postoperative recurrence. This operation is feasible, reliable and effective.