gms | German Medical Science

The success rate of revision tympanoplasties is not uniformly evaluated in the literature. In a retrospective study clinical notes of 250 patients who had a revision tympanoplasty in the Department of Oto-Rhino-Laryngology at the University of Essen were therefore evaluated. The patients mostly had been operated elsewhere before; the most common indication for revision tympanoplasty was recurrent otorrhea. In 89/250 patients who previously had a tympanoplasty type I 79% had a recurrent perforation of the tympanic membrane and in 21% additionally the ossicles had to be reconstructed. In 51/250 patients who previously had a classic type III tympanoplasty (tympanic membrane on stapes) 24% had an eroded stapes suprastructure. In 106/250 patients previously a TORP or PORP had been interposed and this prosthesis was dislocated in 49%.

79 patients were re-evaluated on average 45 months after the revision tympanoplasty. 6/79 patients (8%) had a recurrent perforation of the tympanic membrane. Those patients who were operated with the intention of hearing gain had a closure of the air-bone gap of 9 dB on average. Those patients with an air-bone gap of more than 30 dB had an average postoperative closure of 12 dB. In summary revision tympanoplasties have good results concerning closure of the tympanic membrane as well as hearing gain.