بررسي بيماران مبتلا به رتراكسيون پرده تمپان در 400 بيمار مبتلا به عفونت مزمن گوش مياني

The Evaluation of Tympanic Membrane Retraction in 400 Cases of Chronic Otitis Media

Background and Objectives: The prevalence of tympanic membrane retraction in cases of chronic otitis media who undergo tympanomastoidectomy operation, is high. Diagnosis and treatment of these patients, is one of the major problems in Otolaryngology and itʹs etiology is prolonged malfunction of austachian tube. This problem needs to more investigated and evaluated. The purpose of this study, was to diagnose and treat these patients and prevention of other retraction. Materials and Methods: A total of 400 cases who had tympanomastoidectomy operation in department of Otolaryngology in imam Khomeni Hospital, were reviewed. Forty cases had tympanic membrane retraction. In all of patients, otoscopic and microscopic examination was clone before operation. In 1.9 cases of this group, depth of pocket was visible and amount of conductive hearing loss was 35-45 O. In 21 cases of this group, depth of retraction was not visible by otoscopic and microscopic examination and during operation it was noted that pocket extended to antrum and attic; conductive hearing loss in them was 45-60 dh. Audiotympanometry was done in all of the patients and itʹs type was type 13, with hearing loss in the range of 35-60 dh. Results: In 40 cases who underwent operation, 28 had ossicular necrosis and their operation was done in two stages. First stage was eradication of pathology and second stage was ossicular reconstruction for recovery of conductive hearing loss. In 12 cases, in which the cholesteatoma was present in posterio-superior portion of tympanic membrane and there was no ossicular necrosis, tympanoplasly performed by temporalis fascia. Unfortunatly, in all of Off cases there was some degrees of malfunction in austachian tube. In 8 eases, retraction of tympanic membrane relapsed, in whom graft of perichondrium of tragus was used. During and in Illow-up after second stage up to 18 months, no retraction was observed. Conclusion: Prolonged malfunction of austachian tube, is the major cause of tympanic membrane retraction in posterio-superior portion, in which middle car should he examined carefully and cleaned from pathology, so that the function of austachian tube is returned to normal.