Prognostic factors for graft success in tympanoplasty with mastoidectomy

Abstract

Objective: The aim of this study was to evaluate the different factors that may affect graft success in tympanoplasty with mastoidectomy. Methods: Patients who underwent tympanoplasty with mastoidectomy between September 2004 and July 2010 were included in this study. Patient data were collected retrospectively. The effects of the epitympanic patency, duration of the dry period of the ear, presence of preoperative otorrhea, location of the perforation, status of the middle ear mucosa, and status of the tympanic membrane on the rate of postoperative graft success in patients who underwent tympanoplasty with mastoidectomy were investigated. The chi-square test and Fisher’s exact test were used for statistical analysis. Results: A total of 130 patients, 74 male and 56 female, with an average age of 35.7 (range: 11 to 56) years were included. The overall success rate for full postoperative graft success was 75%. A >3-month dry period of the ear, absence of preoperative otorrhea, preoperative normal middle ear mucosa, and presence of epitympanic patency significantly increased the postoperative success rate of graft (p<0.001). The presence of preoperative otorrhea and granulation tissue in the middle ear mucosa, presence of preoperative myringosclerosis, and lack of epitympanic patency were significantly associated with graft failure after tympanoplasty with mastoidectomy (p<0.001). Conclusion: Epitympanic patency, middle ear infection, and the morphology of the tympanic membrane and middle ear mucosa should be considered prognostic factors in patients who undergo tympanoplasty with mastoidectomy. 

Keywords

• Tympanoplasty,mastoidectomy,prognostic factors,epitympanic patency

Mastoidektomili timpanoplastide greft başarısını etkileyen prognostik faktörler

Öz

Amaç: Çal›flman›n amac› mastoidektomili timpanoplastide greft baflar›s› üzerinde etkisi olabilecek faktörleri araflt›rmakt›r. Yöntem: Bu retrospektif çal›flma, Eylül 2004 ile Temmuz 2010 aras›nda mastoidektomili timpanoplasti amliyat› geçiren olgular›n verileri kullan›larak yürütüldü. Epitimpanik aç›kl›k, kula¤›n kuru kal›fl süresi, preoperatif otore olup olmamas›, perforasyonun yeri, orta kulak mukozas›n›n ve timpanik membran›n durumunun postoperatif greft baflar›s› üzerindeki etkisi araflt›r›ld›. ‹statistiksel analiz için ki-kare ve Fisher exact testleri kullan›ld›. Bulgular: Çal›flmada toplam 130 hasta (56 kad›n, 74 erkek; yafl ortalamas›: 35.7, yafl aral›¤›: 11–56) dahil edildi. Greft baflar› oran› %75 olarak belirlendi. Kula¤›n 3 aydan daha uzun süre kuru kalmas›, preoperatif olarak kulak ak›nt›s› olmamas›, preoperatif normal orta kulak mukozas› ve epitimpanik aç›kl›k oluflu postoperatif greft baflar›s›n› anlaml› flekilde art›rm›flt›r (p<0.001). Preoperatif otore ve orta kulakta granülasyon dokusu varl›¤›, preoperatif miringoskleroz oluflu ve epitimpanik aç›kl›¤›n olmamas› mastoidektomili timpanoplasti sonras› ise mastodiektomili timpanoplasti sonras› greft baflar›s› anlaml› olarak düflüren faktörler olarak izlendi (p<0.001). Sonuç: Çal›flmam›z›n sonuçlar›na göre epitimpanik aç›kl›k, orta kulak enfeksiyonu ve timpanik membran ve orta kulak mukozas›n›n yap›sal özellikleri mastoidektomili timpanoplasti yap›lacak hastalarda prognostik aç›dan önem tafl›maktad›r.

Anahtar Kelimeler

• Timpanoplasti, mastoidektomi, prognostik faktörler, epitimpanik açıklık

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27. Please cite this article as: Yurttaş V, Ural A, Kutluhan A, Bozdemir K. Prognostic factors for graft success in tympanoplasty with mastoidectomy. ENT
28. Updates 2015;5(2):72–75.