Recent outcome of tympanoplasty in the elderly.

Objective: To investigate the outcome of tympanoplasty in the elderly (patients older than 60 years) compared with younger patients. Patients and Study Design: Retrospective review of 87 (28.3%) older patients among a total of 307 patients with chronic otitis media with or without cholesteatoma who were surgically treated at a university hospital by the senior author. Follow-up was systematically provided at the same institution. Interventions: Surgery included tympanoplasty with mastoidectomy performed as the primary procedure in 358 ears. Tympanoplasty was performed with canal-wall-up or canal-wall-down with canal wall reconstruction, ossiculoplasty with autologous or homologous ossicle interposition or columella. Mean follow-up was 30 months (range, 12-70 months). Main Outcome Measures: Pre- and postoperative air- and bone-conduction thresholds were calculated as an average of three speech frequencies (0.5, 1, and 2 kHz). Analysis was subsequently carried out on the postoperative air-bone gap, hearing gain, and postoperative problems such as elevation of the bone-conduction threshold, delayed epithelialization, and reperforation of the eardrum. Statistical analysis was performed by chi-square or Student's t-test. A p value less than 0.05 was considered significant. Results: Compared with results from younger patients, there was no particular disadvantage in postoperative hearing results and complications in the elderly, although preoperative bone-conduction thresholds were gradually worsened with age. Conclusions: There is no contraindication for tympanoplasty in older patients if their physical status is the same or better than what is normal for their chronological age.