ĐÁNH GIÁ KẾT QUẢ PHẪU THUẬT CHỈNH HÌNH TAI GIỮA TYPE IV Ở BỆNH NHÂN VIÊM TAI GIỮA MẠN CÓ CHOLESTEATOMA

Abstract

 Objective: To describe the clinical and paraclinical characteristics in patients with chronic otitis media with cholesteatoma; To evaluate the results of type IV middle ear surgery according to the modified Wullstein classification. Subjects and methods: To study a group of patients diagnosed with chronic otitis media with cholesteatoma who underwent type IV middle ear surgery according to the modified Wullstein classification from March 2017 to September 2024 at the National Otorhinorarynology Hospital of Vietnam. Results: The main functional symptoms were otorrhea and hearing loss (100%), tinnitus (70.0%) and ear pain (45.0%). The lesions on the CT scan were ossicular chain interruption (100%), epitympanic wall erosion (95.0%) and epitympanic ceiling dehiscence (15.0%). The average post-operative follow-up about 20 months showed that the PTA was 50.06±12.6 dB (There was no difference in audiological parameters before and after surgery) but the rate of mild hearing loss (PTA 26-40 dB) reaching 40.0%, moderate hearing loss (PTA 41-55) was 25.0%, moderate-severe hearing loss (PTA 56-70 dB) was 20.0% and severe hearing loss (71-90 dB) was only 15.0%; the average post-operative ABG was 31.4±12.6 dB. The rate of good surgical cavities was 85.0%, fungal infection was 15.0%, and there were no cholesteatoma recurrence cases. Conclusion: Type IV middle ear surgery according to the modified Wullstein classification contributes to preserving and improving hearing and creating stability of the radical mastoidectomy cavity.