Individualized Endoscopic Surgical Treatment According to the Extent of Adhesive Otitis Media

Background: To optimize the oto-endoscopic treatment of patients with adhesive otitis media (AdOM). Methods: In this observational retrospective cohort study, a total of 73 patients (81 ears) diagnosed with AdOM were included. Surgical interventions included insertion of the tympanotomy tube, tympanoplasty, or a combination of both. Follow-up evaluations were carried out at 2 weeks and at 1, 3, 6, and 12 months. Pure tone audiometry was administered between 1 and 3 months post-surgery, and imaging examinations were carried out at 6 months. Results: Tympanotomy tube insertion was performed in 11.1% (9 out of 81) of the cases, while tympanoplasty was performed in 79% (64 out of 81) of the cases, and both procedures were performed in 9.9% (8 out of 81). The rate of tympanoplasty increased with the Sade grade. Postoperatively, air conduction hearing and air-bone gap (ABG) in patients classified as Sade grades III to V showed a significant improvement. Conclusions: The individualized oto-endoscopic surgery significantly improves hearing outcomes in advanced AdOM (Sade grades III-V), as evidenced by reduced ABG. Patients with varying degrees of AdOM require customized treatment approaches. Level of Evidence: 4.