Relationship Between Postoperative Aeration Around the Stapes and Postoperative Hearing Outcome After Canal Wall Down Tympanoplasty With Canal Reconstruction for Cholesteatoma

OBJECTIVES: To evaluate the correlation between postoperative aeration around the stapes and hearing outcome after canal wall down tympanoplasty with canal reconstruction for cholesteatoma. STUDY DESIGN: Retrospective case review. SETTING: University hospital otolaryngology department. PATIENTS: Seventy ears of 65 patients with middle ear cholesteatoma were included. Patients who had fixed or poorly mobile ossicular chain was excluded. INTERVENTIONS: They were underwent canal wall down tympanoplasty with canal reconstruction. Canal wall was reconstructed with the tragal or conchal cartilage and the cortical bone plate. MAIN OUTCOME MEASURES: We measured aeration around the stapes on coronal and axial computed tomographic sections at 1 year after ossiculoplasty and investigated the correlation between postoperative aeration around the stapes and postoperative air-bone gap (using the mean of 0.5-, 1-, and 2-kHz threshold values) at 1 year after ossiculoplasty. We also investigated it for each of Wullstein type and for each of 0.25-, 0.5-, 1-, 2-, and 4-kHz thresholds. RESULTS: Aeration around the stapes was negatively correlated with postoperative air-bone gap (correlation coefficient, -0.53; p < 0.05). Types I and IV tympanoplasty had a higher correlation with postoperative air-bone gap than type III tympanoplasty. The 0.5-KHz frequency had a higher correlation with postoperative air bone gap than other frequencies. CONCLUSION: Measurement of postoperative aeration around the stapes is an effective method for evaluating the importance of middle ear aeration. Aeration around the stapes contributes to better hearing outcome.