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Early hearing evaluation in patients treated by surgery due to chronic otitis

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Olszewski J., Konopka W., Repetowski M.
Otolaryngologia Polska
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2008
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vol. 62(6)
731-734
EN
Intoduction. The aim of the study was the comparison of hearing before and after ear surgery in patients with chronic otitis media according to Fowler and Sabine criteria. Material. The study comprised 42 patients (42 ears), aged 19–72 (26 females and 16 males). The patients were divided into three groups, considering the type of surgery; Group I – 20 ears after myringoplasty, group II – 14 ears after mastoidectomy with canal up and myringoplasty and group III – 8 ears after the mastoidectomy with canal down. Methods. Audiologic examination was performed together with the evaluation of hearing loss according to the criteria of Fowler and Sabine (CPT), before and 3 months after the ear surgery. The difference of 20% (CPT) was considered improvement or deterioration of the hearing. Results. On the basis of the intraoperative examination, chronic otitis media with perforation was found in 18 patients, granulating otitis media in 16 patients and the chronic otitis with cholesteatoma in 8 patients. The myringoplasty was performed in 20 patients, the mastoidectomy with canal up and myringoplasty in 14 patients and the mastoidectomy with canal down in 8 patients. In 14 ears of group I (70%) hearing improvement was noticed, and in 6 (30%) remained unchanged. The mean hearing loss according to CPT in this group was 40,39% before ear surgery and 24,26% after. In group II in 6 ears (43%) hearing improvement was observed, whereas in 8 (57%) remained unchanged. The mean hearing loss according to CPT in this group was 71,40% before and 61,85% after surgical treatment. In group III, hearing improvement was noticed in 37% of ears and in 5 (63%)did not change after the ear operation. The mean hearing loss (CPT) in this group was 81,57% before treatment and 71,37% after. Conclusions. Considering early evaluation of hearing the best results were obtained in patients subjected to myringoplasty and conservative operations of the middle ear with canal up procedure.
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The use of petrosectomy in cochlear implant surgery

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Amernik K., Niemczyk K., Twardowska R., Jaworowska E.
Polski Przegląd Otorynolaryngologiczny
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2020
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vol. 9(2)
1-6
EN
Introduction: The treatment and rehabilitation of hypoacusis with the use of cochlear implants is a safe and reliable method suitable for both children and adults. In people affected by chronic otitis media cholesteatomatosa or such who have previously undergone open repair of the ear, we use a special surgical technique known as lateral/subtotal petrosectomy. Material and methods: The study group consisted of patients with profound bilateral sensorineural hearing loss, in which otitis media with and without cholesteatoma has been diagnosed or after open repair of the middle ear. A retrospective analysis of patient data, as well as radiological and audiological results, was conducted. Results: In the Clinic of Otolaryngology and Laryngological Oncology of the Pomeranian Medical University in the years 2008–2018 we performed 90 cochlear implant surgeries, including a petrosectomy in 1 child with cholesteatoma (5 years) and in 2 adults after open repair (62 and 73 years). In all cases the procedure was done in a single stage. Healing proceeded correctly in all patients undergoing petrosectomy. The observation period ranges from 26 to 32 months, computed tomography examinations revealed no indirect characteristics of recurrent cholesteatoma. The patients remain under constant ENT supervision. The child has risk factors for autism and mental retardation, he displays good auditory responses and speech understanding; he has not developed active speech. As regarding free field pure tone audiometry, in adults hearing in the cochlear implant remains at 35 and 40 dB, and speech understanding at 80%. Discussion: Patients with chronic otitis media can be treated efficiently and safely with a cochlear implant using lateral petrosectomy. Lateral/subtotal petrosectomy is the access of choice when deep sensorimotor hearing loss coexists with chronic inflammation in the middle ear.
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