The treatment of adhesive otitis media using cartilage tympanoplasty with plasma radiofrequency ablation tuboplasty

Abstract

Objective

The long-term outcomes of patients with adhesive otitis media (AdOM) treated with a combination of cartilage tympanoplasty and plasma radiofrequency ablation tuboplasty (PRT) were evaluated.

Material and methods

Cartilage tympanoplasty with PRT was performed in 21 patients (21 ears) with AdOM who met the inclusion criteria. Graft success, hearing improvement, aeration of the tympanic cavity and mastoid computed tomography (CT) scans and complications were evaluated during a 2-year follow-up period.

Results

The mean follow-up was 26.2 ± 1.7 months (range: 24–28 months). Ossiculoplasty was performed in 19.0 % ears. Hyperplasia and edema of the ET orifice mucosa were significantly reduced after PRT. Successful graft healing and hearing improvement were obtained in 100.0 % ears. 90.5 % patients reported ear fullness improvement and tinnitus improvement in 71.4 %. Mean ABG values were 29.5 ± 6.3 preoperatively and 17.4 ± 9.1 postoperatively; the difference was statistically significant (P < 0.01).

The 6-month postoperative CT showed that aeration in the tympanic cavity and mastoid was completely restored in 76.2 %, improved in 19.0 %, and no change in 4.8 %. The 12-month postoperative CT revealed that aeration was completely restored in 85.7 % and improved in 14.3 %. Additionally, among the 20 patients with planned tube removal, CT showed partial poor aeration and endoscopic inspection revealed ET orifice stenosis in 15 %, but good aeration in 85 % patients with spontaneous closure. No adhesion or invagination of the TM was evident during the follow-up period, and no PRT-related complications were detected.

Conclusions

Despite limitations including a small sample size and lack of controls, our study showed that cartilage tympanoplasty with PRT is a safe, simple, and effective surgical method for the management of AdOM.