Can surgical Technique act as a Prognostic Factor for Graft Success Rate in Chronic Otitis Media?

Can surgical Technique act as a Prognostic Factor for Graft Success Rate in Chronic Otitis Media?
Mohammad Faramarzi

Background:Review of literature has resulted in conflicting opinions, whether or not, the surgical technique act as a prognostic factors in graft success rate. This study was conducted to detect the effect of the surgical technique on graft success rate.

Method:retrospective study, on ears undergoing chronic otitis media surgeries ina tertiary referral centersetting. Inclusion criteria were; all primary chronic otitis media surgeries in adults (more than 15 years), patients who suffered from conductive hearing loss. Exclusion criteria were from this study if they met any of the following
criteria: 1) Pediatric patients, 2) Smoker patients, 3) Patients with revision surgery, 4) Patients with preoperative mixed hearing loss, 5) Patients with contra- lateral ear
disease. Five hundred and five ears undergoing chronic otitis media surgeries were analyzed (tympanoplasty (n=225), Canal wall up mastoidectomy (n=93) and canal
wall down mastoidectomy (n=187). Overall graft success rate, graft success rate in each surgical technique and the mean post-operation air-bone gap gain were main
outcomes that measured.

Results:Overall graft success rate was 91.1%. Graft success rate in tympanoplasty, Canal wall up mastoidectomy and canal wall down mastoidectomy were 89.3%, 87.1% and 95.2%, respectively. The mean post-operation air-bone gap gain in these three surgical techniques was 7.8, 11.1 and 4.3 dB, respectively. Conclusions:Our results showed that the overall graft success rate was in the acceptable range. Moreover, graft success rate in canal wall down mastoidectomy was more than tympanoplasty and canal wall up mastoidectomy.