Kemik Çimentosu ile Ossiküloplasti Uygulanan Bireylerde Geniş Bant Timpanogram Bulgularının Değerlendirilmesi

Abstract

Middle ear acts as a tranducer which transform acoustic energy to mechanical waves and transmits the sound to the inner ear. Ossicular chain discontinuity is usually occurs secondary to chronic otitis media and causes conductive type hearing loss. Ossicular chain reconstruction (ossiculoplasty) can be performed by using autologous grafts, prostheses and bone cement. The goal of surgery is to obtain best physiological results regarding middle ear fuction. Bone cement is a considerable option in terms of its good biological tolerability, low extrusion rate and high stability. In our daily practice we perform various ossiculoplasty techniques by using bone cement. Immitansmetry is a widely used, non-invasive, objective test which is applicable in both adult and pediatric patients. Wide band tympanometry (WBT) is an immistansmetric method which is done by a click stimulus with a wide range of frequencies (226-8000 Hz) applied into external ear canal. In present study we aim to investigate WBT results in bone cement ossiculoplasty cases. We retrospectively evaluate bonce cement ossiculoplasty patients and grouped them according to anatomical location of boce cement application. A total of 30 bone cement ossiculoplasty cases as well as 30 intact ossicular chain Type 1 tympanoplasty cases and 30 healthy controls were undergone WBT test. Tympanometric peak presure, equivalent middle ear volume, static admittance, tympanogram range, resonance frequency, average WBT, absorbance measurements at tympanometric peak pressure and ambient were analyzed. Bone cement ossiculoplasty group demonstrated a significant difference than the type 1 tympanoplasty and control group. The most remarkable difference was found in incus-stapes bridging ossiculoplasty group. In some parameters; maaleus-stapes and manubriostapedioplasty group demonstrated similarities to type 1 tympanoplasty and control groups. In tympanometric peak pressure and ambient absorbance measurements there was a significant difference at high frequency between the study and control groups (p˂0.05). Incudostapedial and incudomalleolar joints are different anatomical regions which have diverse mechanical properties. Bone cement is an effective method for ossiculoplasty and wide band tympanometry is a promising method for the evaluation of middle ear dynamics.