Total mastoid obliteration in staged canal-up tympanoplasty for cholesteatoma facilitates tympanic aeration.
نویسندگان
چکیده
OBJECTIVE To assess middle ear aeration after total mastoid obliteration using bone pate and hydroxyapatite performed at the second stage of intact-canal-wall (ICW) tympanoplasty. STUDY DESIGN Retrospective study. SETTING Tertiary referral hospital. PATIENTS Forty-two ears with cholesteatoma underwent the obliteration. Computed tomography (CT) scan 1 week before the second-stage operation showed disturbance of middle ear aeration.In the 27 ears of these cases, temporal bone CT scans taken 3 years or more after the operation were available. INTERVENTION We performed second-stage ICW tympanoplasty 1 year after the first-stage canal-up operation. After mastoidectomy and ossiculoplasty, communication between the tympanic cavity and antrum was blocked with cartilage flaps, and the antrum and mastoid cavity were obliterated totally with bone pate alone or combined with hydroxyapatite granules. MAIN OUTCOME MEASURES Otomicroscopic and otoendoscopic assessment for ear drum retraction was graded. Tympanic aeration assessed with CT when available. RESULTS After the total mastoid obliteration in the second-stage ICW tympanoplasty, no postoperative complications nor residual cholesteatoma were encountered. The incidence of ear drum retraction was significantly correlated with the grade of tympanic aeration. CONCLUSION The total mastoid obliteration done at the second-stage ICW tympanoplasty is a safe procedure that facilitates aeration of the tympanic cavity. In ears with restored tympanic aeration, the probability of a retraction pocket development is low. On the contrary, possibility of retraction pocket development is high in the ears with poor tympanic aeration after the second-stage operation.
منابع مشابه
Postoperative Mastoid Aeration Following Canal Wall Up Mastoidectomy according to Preoperative Middle Ear Disease: Analysis of Temporal Bone Computed Tomography Scans
BACKGROUND AND OBJECTIVES The aim of our study was to evaluate postoperative mastoid aeration according to the preoperative middle ear disease and investigate the factors affecting it. SUBJECTS AND METHODS We retrospectively reviewed the high-resolution computed tomography (CT) scans of temporal bones that were taken 1 year after surgery. The postoperative mastoid aeration was evaluated accor...
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There are two types of cholesteatoma in children, congenital and acquired. The pathogenesis of each type is thought to be different. The pathogenesis of congenital cholesteatoma is thought to be the embryonic inclusion of squamous epithelium, whereas acquired cholesteatoma is thought to develop from various factors including recurrent otitis media and tubal insufficiency. We reviewed a series o...
متن کاملResidual cholesteatoma: incidence and localization in canal wall down tympanoplasty with soft-wall reconstruction.
OBJECTIVE To compare the incidence and localization of residual cholesteatomas in canal wall down tympanoplasty with soft-wall reconstruction with results with the canal wall down and open tympanoplasty or canal wall up tympanoplasty. DESIGN Retrospective case-series study. SETTING Tertiary care university hospital. PATIENTS Eighty-five patients (85 ears) with fresh extensive cholesteatom...
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AIM To describe our surgical technique and compare the results of obliteration materials. PATIENTS AND METHODS Fifty patients over a 7-year period were evaluated retrospectively. Out of these 50 consecutive patients, 29 had recurrent chronic otitis media (COM) with or without cholesteatoma and 21 patients had old open cavities. Efficacy of mastoid obliteration was assessed by an electronic ch...
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ورودعنوان ژورنال:
- Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
دوره 30 6 شماره
صفحات -
تاریخ انتشار 2009