Clinical characteristics and surgical benefits and problems of chronic otitis media and middle ear cholesteatoma in elderly patients older than 70 years

Otol Neurotol. 2012 Sep;33(7):1213-7. doi: 10.1097/MAO.0b013e31825f24ba.

Abstract

Objective: To investigate the benefits and problems of tympanoplasty in elderly patients older than 70 years.

Study design: Retrospective case review.

Setting: Referral hospital otolaryngology department.

Patients: Among 1,014 patients who underwent tympanoplasty for chronic otitis media from 2006 to 2011, those aged over 70 years were eligible for inclusion.

Main outcome measures: Clinical characteristics including tympanosclerosis and preoperative severe complications were investigated. In chronic otitis media group, hearing outcomes (air-bone gap at 500-Hz and 1- and 2-kHz frequency) and postoperative ear condition were investigated. In chronic otitis media with cholesteatoma, clinical characteristics including postoperative bone conduction hearing threshold (at 500-Hz and 1- and 2-kHz frequency) were investigated.

Results: Ninety-seven ears of 83 patients were included. Eighteen ears had obvious findings of tympanosclerosis (18/97 = 18.6%). In chronic otitis media without cholesteatoma (52 ears/47 patients), no preoperative complications were noted. The mean air-bone was 30.8 and 16.1 dB before and after the operation, respectively (p < 0.001). Otorrhea disappeared in 51 ears (98.1%). In chronic otitis media with cholesteatoma (42 ears/33 patients), we noted preoperative severe complications including labyrinthine fistula (7/97 = 7.22%), widely exposed dura (1/97 = 1.03%), and facial palsy 1 (1/97 =1.03%). The mean bone conduction hearing threshold was 39.6 dB and 40.89 dB, respectively (p = 0.7). Three ears of 3 patients had operated ears with open mastoid and underwent canal wall reconstruction tympanoplasty.

Conclusion: Tympanoplasty in elderly patients older than 70 years seems to be as safe as when performed in younger patients.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cholesteatoma, Middle Ear / surgery*
  • Female
  • Humans
  • Male
  • Otitis Media / surgery*
  • Retrospective Studies
  • Treatment Outcome
  • Tympanoplasty / adverse effects*