Outcome of Type 1 Tympanoplasty in Al Nahdha Hospital and Influencing Factors: A Retrospective Study.

Abstract

Objectives: The management for chronic suppurative otitis media is tympanoplasty. The aim of the surgery is to prevent recurrent ear discharge and improve hearing. Several influencing factors are presumed to affect the outcome of tympanoplasty; however, their effect is considered controversial. No study in Oman evaluates the success rate of this surgery. Therefore, this study aimed to evaluate the anatomical and functional outcome of type 1 tympanoplasty in Al Nahdha Hospital, Oman, from 2010 to 2020. In addition, we sought to assess various factors that might have influenced the outcome and add our experience to the literature.

Methods: We conducted a retrospective study that included all patients who had undergone type 1 tympanoplasty in Al Nahdha Hospital. The demographic data for patients were collected, in addition to the preoperative findings, pre- and postoperative air-bone gap (ABG) in a pure tone audiometry, the surgical approaches, and the type of grafts used. The success rate was defined as intact tympanic membrane six months after the surgery, and hearing improvement success was assessed by closure of ABG closure of 10 dB or more.

Results: The total number of patients was 345, 40.6% were male, and 59.4% were female. The graft success rate was 84.3%. The average preoperative ABG was 26.1 ± 9.5, and the average postoperative ABG was 14.4 ± 9.3 with a gain of 11.7. This was statistically significant with a p-value of < 0.001. Hearing improvement (≥ 10 dB gain in ABG) was seen in 201 (67.0%) patients. There was no statistically significant difference in the hearing improvement and graft success rate when compared with influencing factors, including age, gender, perforation size, and surgical approach. However, there was a statistically significant difference between the types of graft used, where cartilage graft showed better hearing improvement than temporalis fascia graft.

Conclusions: The graft success rate of type 1 tympanoplasty in Al Nahdha Hospital was 84.3%, and closure of ABG was 11.7. The percentage of patients who had improvement in ABG closure of ≥ 10 dB was 67.0%. These results are comparable with the results of other published studies. Factors that are presumed to influence the outcome of type 1 tympanoplasty were not statistically significant, which is consistent with other studies. Cartilage graft was found to give a better closure of ABG, which was statistically significant. We recommend that further studies be conducted within a more extended follow-up period and address more factors to achieve a better insight pertaining to the outcome of type 1 tympanoplasty.