Choice of approach for revision surgery in cases with recurring chronic otitis media with cholesteatoma after the canal wall up procedure

2011 ◽  
Vol 38 (2) ◽  
pp. 190-195 ◽  
Author(s):  
Kyung Tae Park ◽  
Jae-Jin Song ◽  
Sung Joong Moon ◽  
Jun Ho Lee ◽  
Sun O Chang ◽  
...  
Keyword(s):  
Otitis Media ◽  
Revision Surgery ◽  
Chronic Otitis Media ◽  
Canal Wall ◽  
Canal Wall Up

Revision Surgery for Chronic Otitis Media: A Learning Experience

1998 ◽  
Vol 107 (6) ◽  
pp. 486-491 ◽  
Author(s):  
Jan E. Veldman ◽  
W. Weibel Braunius
Keyword(s):  
Otitis Media ◽  
Revision Surgery ◽  
Learning Experience ◽  
Chronic Otitis Media ◽  
Canal Wall ◽  
Long Term Follow Up ◽  
Surgical History ◽  
History Of ◽  
Canal Wall Down ◽  
Residual Air

The objective of this study was to evaluate, during a long-term follow-up period, the results of revision surgery for chronic otitis media with or without cholesteatoma. Intact canal wall and canal wall down procedures were performed. The surgical history of every patient was assessed before the operation. A dry, relatively safe, and disease-free ear was created in 90% of the reoperated ears (N = 389). The recurrence rate of cholesteatoma was 5% for the total group. Reperforations of the tympanic membrane occurred in 10%, and persistent or recurrent otorrhea was present in 10% of cases. The functional hearing results were quite satisfactory. A residual air-bone gap of ≤30 dB was reached in 70.3% of the cases after revision tympanoplasty only (N = 41). Revision mastoidectomy with revision tympanoplasty as a one-stage procedure led subsequently, in 76% of intact canal wall procedures (N = 113) and 55% of canal wall down procedures (N = 98), to a residual air-bone gap of ≤30 dB.

Long-term outcome of ossiculoplasty using autogenous mastoid cortical bone

2014 ◽  
Vol 128 (10) ◽  
pp. 866-870 ◽  
Author(s):  
Z Yu ◽  
L Zhang ◽  
D Han
Keyword(s):  
Cortical Bone ◽  
Otitis Media ◽  
Chronic Otitis Media ◽  
Prosthetic Material ◽  
Canal Wall ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Canal Wall Down ◽  
Canal Wall Up

AbstractObjective:To observe the long-term outcome of ossiculoplasty using autogenous mastoid cortical bone in chronic otitis media in-patients.Methods:Sixty-one ears of 57 in-patients with chronic otitis media, with or without cholesteatoma, underwent type III tympanoplasty using autogenous mastoid cortical bone as the prosthetic material. Twenty-one ears were treated by canal wall down mastoidectomy and 40 ears by canal wall up mastoidectomy. The follow-up period was 3 to 6 years (average 4.2 years). Pure tone averages for thresholds at 0.5, 1, 2 and 3 kHz were calculated using standard conventional audiometry.Results:The pre-operative mean air–bone gap of 31.6 dB, for all ears, was reduced to 20.3 dB post-operatively. For the 40 canal wall up ears, this value decreased from 30.8 dB to 19.9 dB, and for the 21 canal wall down ears it decreased from 33.0 dB to 21.0 dB. The differences between the pre- and post-operative mean air–bone gap values were significant.Conclusion:No cases of extrusion, necrosis or resorption were exhibited for the autogenous mastoid cortical bone prosthesis. A significant hearing improvement was obtained in the majority of cases and this remained stable over time.

Modified Canal Wall-Up Mastoidectomy with Mastoid Obliteration for Severe Chronic Otitis media

ORL ◽  
1995 ◽  
Vol 57 (4) ◽  
pp. 198-201 ◽  
Author(s):  
P. Montandon ◽  
M. Benchaou ◽  
J.P. Guyot
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Canal Wall ◽  
Mastoid Obliteration ◽  
Canal Wall Up

Revision surgery for chronic otitis media: recurrent-residual disease and hearing

2002 ◽  
Vol 116 (12) ◽  
pp. 996-1000 ◽  
Author(s):  
Stephen O’Leary ◽  
Jan E. Veldman
Keyword(s):  
Retrospective Analysis ◽  
Otitis Media ◽  
Surgical Approach ◽  
Revision Surgery ◽  
Residual Disease ◽  
Chronic Otitis Media ◽  
Canal Wall ◽  
Persistent Disease ◽  
Canal Wall Down

The aim of this study was to determine the effect of surgical approach, intact canal wall (ICW) or canal wall down (CWD), upon the success of revision surgery for chronicotitis media (COM). A retrospective analysis of 367 patients (including 65 children aged <15years) who underwent revision tympanoplasty because of persistent disease was performed. Single-staged tympanoplasty was performed, preserving the canal wall when present. Hearing was reconstructed with allograft incus. Follow-up ranged from one to 15 years. Hearing was determined by pre- and post-operative air-bone gaps.Post-operative re-perforation, aural discharge and/or cholesteatoma rates were similar for CWD and ICW. Cholesteatoma could present following the revision, even though it was not apparentat surgery. Following tympanoplasty, the final hearing was not significantly affected by the surgical approach or presence of cholesteatoma. Improvement in hearing was adversely affected by cholesteatoma or an absent stapes suprastructure.Revision ICW and CWD operations were both successful in controlling signs of COM. Cholesteatoma is a peripheral risk in COM and may become apparent after revision surgery.

scholarly journals The Efficacy of Mastoid Obliteration in Patients Who Recieved Canal Wall Up Tympanomastoidectomy for Chronic Otitis Media

2019 ◽  
Vol 30 (2) ◽  
pp. 182-188
Author(s):  
Nam Yoon Jung ◽  
Chang Bae Lee ◽  
Sung-Wook Jeong ◽  
Kyung Wook Heo ◽  
Myung Koo Kang
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Canal Wall ◽  
Mastoid Obliteration ◽  
Canal Wall Up

Myringostapediopexy: surgical expectation

2003 ◽  
Vol 117 (3) ◽  
pp. 182-185
Author(s):  
P. J. D. Dawes
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Chronic Otitis Media ◽  
Hearing Level ◽  
Canal Wall ◽  
Similar Range ◽  
Canal Wall Down ◽  
Canal Wall Up

Myringostapediopexy may occur as a result of incus erosion with medialization of the tympanic membrane and is recognized as often producing serviceable hearing. The technique may be used as part of tympanoplasty following either canal wall up or canal wall down surgery for chronic otitis media. The use of this type of reconstruction is influenced by the anatomy of the ear after disease excision. This review of the hearing levels associated with myringostapediopexy shows that there is a similar range of hearing level both for naturally formed as well as surgically fashioned myringostapediopexy. For both ’naturally formed’ and following canal wall up surgery about 80 per cent of patients will have an air-bone gap of 20 dB or less compared to 60 per cent of those who undergo canal wall down surgery.

Endoscopic epitympanic exploration in mucosal chronic otitis media: is canal wall up mastoidectomy really needed?

2021 ◽  
Vol 135 (1) ◽  
pp. 39-44
Author(s):  
A Das ◽  
S Mitra ◽  
S Hazra ◽  
A Sengupta
Keyword(s):  
Otitis Media ◽  
Operating Time ◽  
Chronic Otitis Media ◽  
Canal Wall ◽  
Surgical Time ◽  
Cortical Mastoidectomy ◽  
Post Operative Pain ◽  
Significant Difference ◽  
Canal Wall Up

AbstractObjectiveTo compare endoscopic epitympanic exploration with conventional canal wall up (cortical) mastoidectomy for mucosal chronic otitis media in terms of post-operative outcomes.MethodsSeventy-six patients diagnosed with chronic otitis media (mucosal variety) were randomly assigned to two treatment groups: endoscopic epitympanic exploration and conventional canal wall up (cortical) mastoidectomy. The groups were compared in terms of: post-operative anatomical outcomes (graft uptake), middle-ear physiological outcomes (post-operative tympanometry), audiological outcomes (air–bone gap), surgical time, post-operative pain, vertigo, and long-term complications such as retraction pocket and re-perforation.ResultsThere was a statistically significant difference between the groups in terms of mean air–bone gap at 12 months, surgical time, and median post-operative pain measured at 6 hours (p < 0.05). No statistically significant differences were noted in terms of: graft uptake at 1, 3 and 6 months, mean air–bone gap at 3 and 6 months, tympanometry at 3, 6 and 12 months, vertigo at 1 week, or long-term complications.ConclusionEndoscopic epitympanic exploration resulted in significantly better long-term audiological outcomes, shorter operating time and less pain compared with conventional canal wall up (cortical) mastoidectomy.

scholarly journals Relation between Ossicular Erosion and Destruction of Facial and Lateral Semicircular Canals in Chronic Otitis Media

2016 ◽  
Vol 21 (03) ◽  
pp. 239-242 ◽  
Author(s):  
Suphi Bulğurcu ◽  
İlker Arslan ◽  
Bünyamin Dikilitaş ◽  
İbrahim Çukurova
Keyword(s):  
Facial Nerve ◽  
Otitis Media ◽  
Chronic Otitis Media ◽  
Semicircular Canals ◽  
Ossicular Chain ◽  
Facial Canal ◽  
Canal Wall ◽  
Radical Mastoidectomy ◽  
Canal Wall Down ◽  
Canal Wall Up

Introduction Chronic otitis media can cause multiple middle ear pathogeneses. The surgeon should be aware of relation between ossicular chain erosion and other destructions because of the possibility of complications. Objective This study aimed to investigate the rates of ossicular erosion in cases of patients with and without facial nerve canal destruction, who had undergone mastoidectomy due to chronic otitis media with or without cholesteatoma. Methods We retrospectively analyzed three hundred twenty-seven patients who had undergone tympanomastoidectomy between April 2008 and February 2014. We documented the types of mastoidectomy (canal wall up, canal wall down, and radical mastoidectomy), erosion of the malleus, incus and stapes, and the destruction of facial and lateral semi-circular canal. Results Out of the 327 patients, 147 were women (44.95%) and 180 were men (55.04%) with a mean age 50.8 ± 13 years (range 8–72 years). 245 of the 327 patients (75.22%) had been operated with the diagnosis of chronic otitis media with cholesteatoma. FNCD was present in 62 of the 327 patients (18.96%) and 49 of these 62 (79.03%) patients had chronic otitis media with cholesteatoma. The correlation between the presence of FNCD with LSCC destruction and stapes erosion in chronic otitis media with cholesteatoma is statistically significant (p < 0.05). Conclusion Although incus is the most common of destructed ossicles in chronic otitis media, facial canal destruction is more closely related to stapes erosion.

Correlation of pre-operative computed tomography, intra-operative findings and surgical outcomes in revision tympanomastoidectomy

2021 ◽  
pp. 1-7
Author(s):  
A Košec ◽  
V Matišić ◽  
T Gregurić ◽  
H Falak ◽  
J Ajduk ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Otitis Media ◽  
Surgical Procedures ◽  
Revision Surgery ◽  
Surgical Outcomes ◽  
Recurrent Disease ◽  
Chronic Otitis Media ◽  
Canal Wall ◽  
Computed Tomography Scans ◽  
Operative Findings

Abstract Objective To correlate pre-operative computed tomography findings, intra-operative details and surgical outcomes with cholesteatoma recurrence in revision tympanomastoidectomy. Methods This retrospective, non-randomised, single-institution cohort study included 42 patients who underwent pre-operative computed tomography imaging and revision surgery for recurrent chronic otitis media. Twelve disease localisations noted during revision surgery were correlated with pre-operative temporal bone computed tomography scans. A matched pair analysis was performed on patients with similar intra-operative findings, but without pre-operative computed tomography scans. Results Pre-operative computed tomography identified 25 out of 31 cholesteatoma recurrences. Computed tomography findings correlated with: recurrent cholesteatoma when attic opacification and ossicular chain involvement were present; and revision surgery type. Sinodural angle disease, posterior canal wall erosion and dehiscent dura were identified as predictors of canal wall down tympanomastoidectomy. Patients with pre-operative computed tomography scans had a higher rate of cholesteatoma recurrence, younger age at diagnosis of recurrent disease, more revision surgical procedures and less time between previous and revision surgical procedures (all p < 0.05). Conclusion Pre-operative imaging and intra-operative findings have important clinical implications in revision surgery for chronic otitis media. Performing pre-operative computed tomography increases diagnosis accuracy and reduces the time required to diagnose recurrent disease.

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