Personalized prediction of the results of reconstructive surgery for chronic otitis media

Abstract

Introduction. The goal of the surgical treatment of patients with chronic otitis media is to eliminate the consequences of the inflammatory and destructive disease while preserving the anatomy of the middle ear and improving auditory function. According to the literature, the outcome of middle ear reconstructive surgery for the surgeon and the patient in most cases remains unpredictable. The development of an integrated approach to predicting the results of reconstructive sanitizing surgery will make it  possible to select the most effective surgical tactics in terms of treatment time and type of surgical intervention.Aim.To develop a methodology for personalized prediction of the result of operations on the temporal bone in patients with chronic otitis media and substantiate the choice of optimal surgical tactics, taking into account clinical and functional parameters.Materials and methods.A retrospective study was carried out to compare the data of patients with the use of the author’s personalized prognosis method: “A method for predicting the result of tympanoplasty” and “A method for predicting the degree of  hearing loss in otosurgery for chronic otitis media” with the results of surgical treatment of 263 patients with chronic otitis media, operated on in hospitals in Moscow. Chelyabinsk in 2018–2020.Results and discussion. In the observation, the patients were divided into two groups according to the sum of points, which determined the volume, type and timing of the operation. The sum of points less than or equal to 20 was assessed as a favorable prognosis for reconstructive debridement surgery. The sum of points in the range from 21–40 was assessed as the possibility of carrying out onestage surgery for the purpose of sanitation and reconstruction, but the patient should be informed about the unfavorable prognosis for the restoration of hearing. A score greater than 40 is assessed as an unfavorable prognosis, with an indication for separate-stage surgery, indicating a socially significant hearing loss in the postoperative period in patients with chronic otitis media.Conclusion. A personalized approach to predicting the results of surgical treatment forms groups of patients with chronic suppurative otitis media and helps in choosing surgical tactics in terms of the type, volume and timing of one-stage or separatestage reconstructive surgery and the need for reoperation for a period of one year.