Clinical Characteristics of Chronic Perforated Otitis Media in Different Age Groups

INTRODUCTION Chronic perforated otitis media, which is usually caused by severe or recurrent otitis media in childhood, can cause gradual deterioration of residual hearing. Therefore, early surgical intervention is desirable. Many researchers have investigated the relationship between age and the results of tympanoplasty in chronic otitis media [1, 2]. Tympanoplasty in elderly patients is acceptable nowadays, and some have noted that postoperative hearing results are significantly improved in elderly patients and that there are no disadvantages in results compared to younger patients [3, 4], although preoperative bone-conduction thresholds gradually worsen with age. It is, however, often recognized during the operation that tympanoplasty can be technically more difficult in elderly patients than in younger patients because of severe middle ear conditions, including mucosal inflammation, tympanosclerosis, and destruction of the ossicular chain. To clarify the factors that influence the surgical outcomes in different age groups, in this study we investigated differences including mastoid maturation and surgical procedure among patients in younger, middle, and elderly age groups. Especially by comparing mastoid pneumatization in patients grouped in the different ages, the area of pneumatization might be a consequence of not only long lasting but also severe and intractable inflammation influenced by the therapeutic methods and surrounding environmental factors in early medical history.