HIV Positivity per se Does Not Affect Tympanoplasty Outcomes.

Background: The English language literature finds no clear protocols for otologic surgery for HIV+ patients.

Objective: To demonstrate that simple tympanoplasty and type III tympanoplasty in HIV+ patients with CD4 >400 cells/cc results in tympanic membrane closures and hearing improvements equivalent to the same procedures in controls.

Materials And Methods: This retrospective review documents the otologic conditions and operative results of 32 HIV+ patients and 32 controls. The controls were healthy and had no opportunistic infections or other medications.

Results: Genders, ages, sizes of tympanic membrane perforations, severity of air bone gaps, and type of operation were equivalent between the HIV+ and the control groups. Thirty of 32 patients in each group had closure of their perforations after 1 operation. Air bone gaps improved significantly for each group ( P = .001): 22 dB (SD = 11 dB) in the HIV+ group and 26 dB (SD = 10 dB) in the control group. And there was no statistically significant difference in change in hearing between the 2 groups. There were no complications of infection, wound dehiscence, worsened sensorineural levels, dizziness, or facial weakness in either group.

Conclusion: HIV+ patients whose CD4 counts are above 400 cells/cc can undergo simple tympanoplasty or type III tympanoplasty with acceptable outcomes.