- 期刊
60歲以上患者接受第一型鼓室成形手術之預後
Prognosis of Tympanoplasty Type I in Patients Older than 60 Years
摘要
BACKGROUND: Due to poor medical and health care before, many patients with chronic otitis media suffer from recurrent otorrhea and hearing loss for a long time. The current demographic trend is toward an aging society and there is a greater demand by elderly patient to obtain a better quality of life and take part in social activities. Therefore, the opportunity to patient undergoes an operation is more frequent. However, surgical decisions for elderly patients are sometimes very difficult for many reasons. To reduce their hesitation to undergo tympanoplasty, we focus on patients older than 60 years who underwent type I tympanoplasty and evaluate their prognosis.METHODS: We reviewed charts of consecutive 39 patients undergoing type I tympanoplasty and followed up between the period of April 1996 and December 2012 in Chung Shan Medical University Hospital. Analysis of graft take rate, postoperative hearing gain, air-bone gap, total success rate of operation and prognostic factors of fascia graft take were carried out.RESULTS: Graft take rate of type I tympanoplasty in patients older than 60 years was approximately 92.3%. There was statistically significant difference in post-operative hearing gain and air-bone gap. According to the criteria of Japan Clinical Otology Committee, total success rate of type I tympanoplasty is 61.5%. Analysis of prognostic factors of fascia graft take, we found that only revision tympanoplasty has negative effect and was statistically significant difference (p ＜ 0.05).CONCLUSIONS: Our result showed high graft take rate and notable post-operative hearing gain in patients older than 60 years who underwent type I tympanoplasty. Even though accompanying systemic disease, they could undergo operation if under well controlled, careful preoperative assessment and proper post-operative care. Therefore, type I tympanoplasty is a safe and beneficial surgery for patients older than 60 years.
並列摘要
BACKGROUND: Due to poor medical and health care before, many patients with chronic otitis media suffer from recurrent otorrhea and hearing loss for a long time. The current demographic trend is toward an aging society and there is a greater demand by elderly patient to obtain a better quality of life and take part in social activities. Therefore, the opportunity to patient undergoes an operation is more frequent. However, surgical decisions for elderly patients are sometimes very difficult for many reasons. To reduce their hesitation to undergo tympanoplasty, we focus on patients older than 60 years who underwent type I tympanoplasty and evaluate their prognosis.METHODS: We reviewed charts of consecutive 39 patients undergoing type I tympanoplasty and followed up between the period of April 1996 and December 2012 in Chung Shan Medical University Hospital. Analysis of graft take rate, postoperative hearing gain, air-bone gap, total success rate of operation and prognostic factors of fascia graft take were carried out.RESULTS: Graft take rate of type I tympanoplasty in patients older than 60 years was approximately 92.3%. There was statistically significant difference in post-operative hearing gain and air-bone gap. According to the criteria of Japan Clinical Otology Committee, total success rate of type I tympanoplasty is 61.5%. Analysis of prognostic factors of fascia graft take, we found that only revision tympanoplasty has negative effect and was statistically significant difference (p ＜ 0.05).CONCLUSIONS: Our result showed high graft take rate and notable post-operative hearing gain in patients older than 60 years who underwent type I tympanoplasty. Even though accompanying systemic disease, they could undergo operation if under well controlled, careful preoperative assessment and proper post-operative care. Therefore, type I tympanoplasty is a safe and beneficial surgery for patients older than 60 years.
延伸閱讀
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