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Abstract：
BACKGROUND: A clinical condition known as chronic otitis media (COM) is characterized by tympanic membrane perforation, varying degrees of hearing loss, and otorrhea that lasts for two to six weeks. COM alone or with cholesteatoma may result in ossicular chain discontinuity and ossicular erosion. The hearing restoration procedure includes repairing the eardrum and building the ossicular chain in ears with damaged ossicles. Multiple studies suggest the predictive value of preoperative air-bone gap (ABG) to detect the ossicular chain status can help with proper preoperative planning for surgery.
OBJECTIVE: To determine the degree of hearing improvement and reduction in ABG after tympanoplasty and to investigate the correlation between preoperative ABG and the status of the ossicular chain during surgery. Study design, setting, and date: This retrospective hospital file-based study was conducted at Aseer Central Hospital, Southern Region, Saudi Arabia, between November 2022 and April 2023. Hospital records of patients who underwent tympanoplasty during 2018-2023 were reviewed. Eighty-five patients were diagnosed with chronic suppurative otitis media (CSOM) between 2018 and 2023. A data collection sheet was employed to record extracted data, including the patient\'s age, sex, hearing assessment, type of surgical intervention, and outcome. We calculated the average of ABG decibels (dB) by summing the ABG values at 500 Hz, 1000 Hz, and 2000 Hz frequencies and dividing by three.
RESULTS: In the present study, data from 85 patients who underwent tympanoplasty were analyzed. Approximately one-third of the patients were in the age group of 31 to 40 years (25, 29.4%), and 50 (58.8%) of them were females. Chronic medical conditions were observed in 30 (35.3%) patients, with diabetes being reported in 19 (63.3%) of those cases. CSOM was found to be present in the left ear of 47 (56.0%) patients. Among the patients, 25 (29.4%) had subtotal perforations, 12 (14.1%) had marginal perforations, and two (2.4%) had total tympanic membrane perforations. The majority of patients (67, 78.8%) exhibited conductive hearing loss, while the remaining 18 (21.2%) had mixed hearing loss. Of the patients, 13 (15.3%) and 20 (23.5%) had fixed and disrupted ossicular chains, respectively. In terms of ossicular disruption, incudostapedial joint (ISJ) fixing (21.2%), fixed stapes (18.2%), and ISJ dislocation (18.2%) were the most prevalent kinds. Prior to operations, the mean ± SD of ABG was 22.6 ± 7.5. ABG values were 19.0 ± 9.3 on average after surgery. The statistical difference between pre- and postoperative ABG was statistically significant (paired t-test, p = 0.007), with a mean difference of -3.7. There were no significant differences between the different statuses of ossicular chains and the type of tympanic membrane perforation.
CONCLUSIONS: This study suggests that the degree of preoperative ABG (dB) is a valuable predictor of intraoperative ossicular chain status and can aid in preoperative planning for ossicular chain reconstruction. Furthermore, the study found that the type of tympanic membrane perforation preoperatively is not a reliable indicator of the ossicular chain status. Finally, tympanoplasty is considered a beneficial surgical procedure with a significant improvement in hearing status postoperatively.
OBJECTIVE: To determine the degree of hearing improvement and reduction in ABG after tympanoplasty and to investigate the correlation between preoperative ABG and the status of the ossicular chain during surgery. Study design, setting, and date: This retrospective hospital file-based study was conducted at Aseer Central Hospital, Southern Region, Saudi Arabia, between November 2022 and April 2023. Hospital records of patients who underwent tympanoplasty during 2018-2023 were reviewed. Eighty-five patients were diagnosed with chronic suppurative otitis media (CSOM) between 2018 and 2023. A data collection sheet was employed to record extracted data, including the patient\'s age, sex, hearing assessment, type of surgical intervention, and outcome. We calculated the average of ABG decibels (dB) by summing the ABG values at 500 Hz, 1000 Hz, and 2000 Hz frequencies and dividing by three.
RESULTS: In the present study, data from 85 patients who underwent tympanoplasty were analyzed. Approximately one-third of the patients were in the age group of 31 to 40 years (25, 29.4%), and 50 (58.8%) of them were females. Chronic medical conditions were observed in 30 (35.3%) patients, with diabetes being reported in 19 (63.3%) of those cases. CSOM was found to be present in the left ear of 47 (56.0%) patients. Among the patients, 25 (29.4%) had subtotal perforations, 12 (14.1%) had marginal perforations, and two (2.4%) had total tympanic membrane perforations. The majority of patients (67, 78.8%) exhibited conductive hearing loss, while the remaining 18 (21.2%) had mixed hearing loss. Of the patients, 13 (15.3%) and 20 (23.5%) had fixed and disrupted ossicular chains, respectively. In terms of ossicular disruption, incudostapedial joint (ISJ) fixing (21.2%), fixed stapes (18.2%), and ISJ dislocation (18.2%) were the most prevalent kinds. Prior to operations, the mean ± SD of ABG was 22.6 ± 7.5. ABG values were 19.0 ± 9.3 on average after surgery. The statistical difference between pre- and postoperative ABG was statistically significant (paired t-test, p = 0.007), with a mean difference of -3.7. There were no significant differences between the different statuses of ossicular chains and the type of tympanic membrane perforation.
CONCLUSIONS: This study suggests that the degree of preoperative ABG (dB) is a valuable predictor of intraoperative ossicular chain status and can aid in preoperative planning for ossicular chain reconstruction. Furthermore, the study found that the type of tympanic membrane perforation preoperatively is not a reliable indicator of the ossicular chain status. Finally, tympanoplasty is considered a beneficial surgical procedure with a significant improvement in hearing status postoperatively.
摘要：
背景：一种称为慢性中耳炎（COM）的临床疾病的特征是鼓膜穿孔，不同程度的听力损失,和持续两到六周的耳漏。单独或伴有胆脂瘤的COM可能导致听骨链不连续和听骨侵蚀。听力恢复程序包括修复耳膜并在听骨受损的耳朵中建立听骨链。多项研究表明，术前气-骨间隙（ABG）检测听骨链状态的预测价值可以帮助正确的术前计划手术。
目的：确定鼓室成形术后ABG的听力改善和降低程度，并探讨术前ABG与手术中听骨链状态的相关性。研究设计,设置,日期：这项基于医院档案的回顾性研究是在Aseer中心医院进行的，南部地区,沙特阿拉伯,2022年11月至2023年4月。回顾了2018-2023年期间接受鼓室成形术的患者的医院记录。在2018年至2023年之间，有85名患者被诊断出患有慢性化脓性中耳炎（CSOM）。使用数据收集表来记录提取的数据，包括病人的年龄,性别,听力评估,手术干预的类型，和结果。我们通过对500Hz的ABG值求和来计算ABG分贝（dB）的平均值，1000Hz,和2000Hz频率并除以3。
结果：在本研究中，对85例接受鼓室成形术的患者的数据进行分析.大约三分之一的患者年龄在31至40岁（25,29.4%），其中50人(58.8%)为女性。在30例(35.3%)患者中观察到慢性医疗状况，其中19例(63.3%)报告了糖尿病。发现CSOM存在于47例（56.0％）患者的左耳中。在患者中,25（29.4%）有小计穿孔，12（14.1%）有边缘穿孔，两个（2.4％）的鼓膜穿孔总数。大多数患者（67，78.8％）表现出传导性听力损失，其余18人（21.2％）患有混合性听力损失。在患者中，13（15.3％）和20（23.5％）有固定和破坏的听骨链，分别。在听骨破坏方面，cendostapealjoint(ISJ)fixing(21.2%),固定骨（18.2%），ISJ位错(18.2%)是最常见的位错类型。在操作之前,ABG的平均值±SD为22.6±7.5。术后ABG值平均为19.0±9.3。术前、术后ABG差异有统计学意义(配对t检验,p=0.007),平均差异为-3.7。听骨链的不同状态和鼓膜穿孔的类型之间没有显着差异。
结论：这项研究表明，术前ABG程度（dB）是预测术中听骨链状态的一个有价值的指标，可以帮助术前规划听骨链重建。此外，研究发现，术前鼓膜穿孔类型不是听骨链状态的可靠指标。最后,鼓室成形术被认为是一种有益的外科手术，术后听力状态显着改善。
目的：确定鼓室成形术后ABG的听力改善和降低程度，并探讨术前ABG与手术中听骨链状态的相关性。研究设计,设置,日期：这项基于医院档案的回顾性研究是在Aseer中心医院进行的，南部地区,沙特阿拉伯,2022年11月至2023年4月。回顾了2018-2023年期间接受鼓室成形术的患者的医院记录。在2018年至2023年之间，有85名患者被诊断出患有慢性化脓性中耳炎（CSOM）。使用数据收集表来记录提取的数据，包括病人的年龄,性别,听力评估,手术干预的类型，和结果。我们通过对500Hz的ABG值求和来计算ABG分贝（dB）的平均值，1000Hz,和2000Hz频率并除以3。
结果：在本研究中，对85例接受鼓室成形术的患者的数据进行分析.大约三分之一的患者年龄在31至40岁（25,29.4%），其中50人(58.8%)为女性。在30例(35.3%)患者中观察到慢性医疗状况，其中19例(63.3%)报告了糖尿病。发现CSOM存在于47例（56.0％）患者的左耳中。在患者中,25（29.4%）有小计穿孔，12（14.1%）有边缘穿孔，两个（2.4％）的鼓膜穿孔总数。大多数患者（67，78.8％）表现出传导性听力损失，其余18人（21.2％）患有混合性听力损失。在患者中，13（15.3％）和20（23.5％）有固定和破坏的听骨链，分别。在听骨破坏方面，cendostapealjoint(ISJ)fixing(21.2%),固定骨（18.2%），ISJ位错(18.2%)是最常见的位错类型。在操作之前,ABG的平均值±SD为22.6±7.5。术后ABG值平均为19.0±9.3。术前、术后ABG差异有统计学意义(配对t检验,p=0.007),平均差异为-3.7。听骨链的不同状态和鼓膜穿孔的类型之间没有显着差异。
结论：这项研究表明，术前ABG程度（dB）是预测术中听骨链状态的一个有价值的指标，可以帮助术前规划听骨链重建。此外，研究发现，术前鼓膜穿孔类型不是听骨链状态的可靠指标。最后,鼓室成形术被认为是一种有益的外科手术，术后听力状态显着改善。
