Role of preoperative air-bone gap in tinnitus outcome after tympanoplasty for chronic otitis media with tinnitus

Publication date: Available online 14 February 2017
Source:Brazilian Journal of Otorhinolaryngology
Author(s): Hong Chan Kim, Chul Ho Jang, Young Yoon Kim, Jong Yuap Seong, Sung Hoon Kang, Yong Beom Cho
IntroductionPrevious reports indicated that middle ear surgery might partially improve tinnitus after surgery. However, until now, no influencing factor has been determined for tinnitus outcome after middle ear surgery.ObjectiveThe purpose of this study was to investigate the association between preoperative air-bone gap (ABG) and tinnitus outcome after tympanoplasty type I.MethodsSeventy-five patients with tinnitus who had more than 6 months of symptoms of Chronic Otitis Media (COM) on the ipsilateral side that were refractory to medical treatment were included in this study. All patients were evaluated through otoendoscopy, pure tone/speech audiometer, questionnaire survey using Visual Analog Scale (VAS) and Tinnitus Handicap Inventory (THI) for tinnitus symptoms before and 6 months after tympanoplasty. The influence of preoperative Bone Conduction (BC), preoperative ABG, and postoperative ABG on tinnitus outcome after the operation was investigated.Results and conclusionThe patients were divided into two groups based on preoperative BC of less than 25dB (n=50) or more than 25dB (n=25). The postoperative improvement of tinnitus in both groups showed statistical significance. Patients whose preoperative ABG was less than 15dB showed no improvement in postoperative tinnitus using VAS (p=0.889) and THI (p=0.802). However, patients whose preoperative ABG was more than 15dB showed statistically significant improvement in postoperative tinnitus using VAS (p<0.01) and THI (p=0.016). Postoperative change in tinnitus showed significance compared with preoperative tinnitus using VAS (p=0.006). However, the correlation between reduction in VAS score and ABG (p=0.202) or between reduction in THI score and ABG (p=0.290) was not significant. We suggest that the preoperative ABG can be a predictor of tinnitus outcome after tympanoplasty in COM with tinnitus.



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