MIDDLE-EAR AIR INJECTION AFTER CHRONIC EAR SURGERY

In the early period after chronic ear surgery, the reasons for conduct ive hearing loss may be difficult to determine. Patients who cannot au toinflate the middle ear after 3 weeks, or who have a negative Rinne t est result with the 512 Hz tuning fork, are treated with a transtympan ic injection of 0.5 cc of air with a 27-gauge needle and tuberculin sy ringe. This represents 20% of patients who had chronic ear surgery. Re sults show that hearing may be immediately improved, the sensation of pressure in the ear may be reduced, and fluid may be cleared from the middle ear. Other benefits may include the release of adhesions. The s urgeon is better able to assess the thickness of the graft, and the st atus of the ossicular chain reconstruction can be determined. There ha ve been no complications of middle ear infection or failure of the mic ropuncture site to heal. In our practice, middle ear air injection is a routine procedure in patients with inadequate eustachian tube functi on after chronic ear surgery. This report describes the results of 100 patients over 14 years who received middle ear air injections after c hronic ear surgery compared with a control group of 100 patients who d id not meet the criteria for requiring air injection. Hearing was imme diately improved in 74% of patients as determined by Rinne testing. Au diograms were performed in 25 of these patients, documenting a mean im provement in pure-tone average of 16 dB. The long-term hearing results in patients undergoing air injection, who by definition had evidence of poor eustachian tube function, are similar to the results in the co ntrol group. This may indicate a lasting benefit of air injection.