[Differential atticoanthrotomy with type 1 tympanoplasty as the method of choice for the treatment of chronic perforating otitis media with expressed mucositis].

The authors report the results of surgical treatment of 37 patients (42 ears) presenting with chronic perforating otitis media and grade I-III mucositis. All the patients were treated by differential atticoanthrotomy with type 1 tympanoplasty. Most of them suffered seriously disturbed ventilation and drainage functions of the Eustachian tube. Mean bone conduction and air conduction audibility thresholds for the voice frequency (0.5-2 kHz) prior to surgery were 12.5 +/- 6.7 and 12.0 +/- 4.2, 14.2 +/- 4.6 and 45.1 +/- 11.7 dB, 46.2 +/- 8.4 and 58.4 +/- 8.6 dB, respectively. Large defects of the tympanic membrane necessitated the use of a composite flap (autofascia and autocartilage) as the tympanic membrane autograft. Excellent survival of the tympanic autograft was documented in 33 (78.6%) patients. The remaining 9 patients had perforations in the neotympanic membrane of different size. Mean bone conduction and air conduction audibility thresholds for the voice frequency upon discharge from the clinic were 14.3 +/- 4.2, 14.0 +/- 4.4, 16.2 +/- 4.2 and 35.9 +/- 12.4 dB, 36.2 +/- 10.4, 46.6 +/- 8.2 dB, respectively. The functional outcome of the surgical treatment further improved in half a year due to the fact that the sound-conducting system acquired a higher rigidity (mean audibility thresholds for air conduction became 32.6 +/- 8.4, 34.0 +/- 6.8, and 42.2 +/- 8.4 dB. Audibility thresholds for bone conduction remained practically unaltered compared with their vales upon discharge from the clinic.