Hearing results of canal wall reconstruction tympanoplasty for middle ear cholesteatoma in children

The aim of this study was to evaluate the hearing results of ossiculoplasty in canal wall down tympanoplasty in one stage middle-ear cholesteatoma surgery.We carried out a retrospective review of a consecutive series of 142 cases which had undergone type two or three canal wall down tympanoplasty with ossicular reconstruction, between January 1995 and December 2002, due to chronic otitis media with cholesteatoma.Pre-operative audiometric testing revealed a mean air conduction pure tone average (PTA) of 50.97 dB and a mean bone conduction PTA of 22.14 dB. The mean post-operative result for air conduction PTA was 37.62 and for bone conduction PTA was 23.37 dB. The mean pre- and post-operative air–bone gaps (ABGs) were 28.83 and 13.94 dB, respectively, with a gain of 14.89 dB. Almost 62.67 per cent of patients closed their ABGs to within 20 dB.Our functional results are comparable with those of other authors. In the present study, we show that hearing improvement is possible following cholesteatoma surgery with canal wall down tympanoplasty and ossicular chain reconstruction.

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Surgical Results of Canal Wall Reconstruction Tympanoplasty in Middle Ear Cholesteatoma.

Nippon Jibiinkoka Gakkai Kaiho ◽

10.3950/jibiinkoka.104.843 ◽

2001 ◽

Vol 104 (9) ◽

pp. 843-851

Author(s):

Kyoko Nomura ◽

Yukiko Iino ◽

Kazuoki Kodera ◽

Jun-Ichi Suzuki

Keyword(s):

Middle Ear ◽

Surgical Results ◽

Canal Wall ◽

Middle Ear Cholesteatoma ◽

Canal Wall Reconstruction

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Canal wall down tympanoplasty with canal reconstruction for middle-ear cholesteatoma: post-operative hearing, cholesteatoma recurrence, and status of re-aeration of reconstructed middle-ear cavity

The Journal of Laryngology & Otology ◽

10.1258/00222150360600823 ◽

2003 ◽

Vol 117 (4) ◽

pp. 249-255 ◽

Cited By ~ 21

Author(s):

Minoru Ikeda ◽

Shinya Yoshida ◽

Akihiro Ikui ◽

Shuntaro Shigihara

Keyword(s):

Middle Ear ◽

The State ◽

Mastoid Cavity ◽

Tympanic Cavity ◽

Canal Wall ◽

Hearing Results ◽

Middle Ear Cholesteatoma ◽

High Incidence ◽

Operative Outcome ◽

Canal Wall Down

The post-operative outcome of hearing, the reconstructed external auditory canal, and the state of the reconstructed middle-ear cavity after canal wall down tympanoplasty with canal and attico-antrum reconstruction was studied in 103 ears with middle-ear cholesteatoma. The reconstructed mastoid cavity was re-aerated in 36.5 per cent of the cases, which was significantly lower than for the epitympanum (63.5 per cent) and tympanic cavity (82.4 per cent). Tympanoplasty was successful in terms of hearing results in 68.9 per cent of all subjects and in 75.4 per cent of the ears having a re-aerated tympanic cavity, which was significantly better than the 38.5 per cent for ears in which the tympanic cavity was not re-aerated. The findings of recurrent cholesteatoma, tympanic atelectasis, and tympanic effusion were observed with significantly (p<0.03) high incidence in ears with no re-aerated space in their reconstructed mastoid cavities. It was revealed that the post-operative outcome of this surgical technique was significantly related to the state of re-aeration of the reconstructed middle-ear cavity.

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The use of rigid endoscopes in cholesteatoma surgery

The Journal of Laryngology & Otology ◽

10.1017/s0022215100126611 ◽

1994 ◽

Vol 108 (4) ◽

pp. 307-309 ◽

Cited By ~ 24

Author(s):

Matthew Man Wah Yung

Keyword(s):

Middle Ear ◽

Complete Removal ◽

Open Cavity ◽

Operating Microscope ◽

Canal Wall ◽

Small Cavity ◽

Mastoid Operation ◽

Canal Wall Reconstruction ◽

Cholesteatoma Surgery

AbstractThe existence of blind pockets in the middle ear during cholesteatoma surgery could compromise complete removal of the disease, e.g. from the sinus tympanum. The use of side-viewing rigid endoscopes in conjunction with the operating microscope to control and facilitate cholesteatoma removal during mastoid operation studied.Ninety-two primary operations for cholesteatoma over a four-year period were examined. Over one-third (35.9 per cent) of these cases had cholesteatoma extended into the sinus tympanum. Sixty-four operations were small cavity mastoidectomy. The others were either canal wall reconstruction or primary obliteration following open cavity mastoidectomy.Although residual cholesteatoma was found in three patients, only one was in the middle ear. It is concluded from this study that side-viewing endoscopes could be very useful in cholesteatoma surgery.

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Correlation between functional outcome and the SAMEO-ATO framework

European Archives of Oto-Rhino-Laryngology ◽

10.1007/s00405-021-07000-3 ◽

2021 ◽

Author(s):

Vito Pontillo ◽

Marialessia Damiani ◽

Giusi Graziano ◽

Nicola Quaranta

Keyword(s):

Functional Outcome ◽

Middle Ear ◽

Petrous Bone ◽

Canal Wall ◽

Hearing Results ◽

Tertiary Referral Center ◽

Ossicular Reconstruction ◽

Canal Wall Down ◽

Mastoid Surgery ◽

Canal Wall Up

Abstract Purpose To evaluate the recently proposed SAMEO-ATO framework for middle ear and mastoid surgery, by correlating it with the functional outcome in a large cohort of patients operated for middle ear and mastoid cholesteatoma in a tertiary referral center. Methods We retrospectively included all surgeries for middle ear and mastoid cholesteatoma undergone in our Department between January 2009 and December 2014, by excluding revision surgeries, congenital and petrous bone cholesteatoma. All surgeries were classified according to the SAMEO-ATO framework. The post-operative air bone gap (ABG) was calculated and chosen as benchmark parameter for the correlation analysis. Results 282 consecutive surgeries for middle ear and mastoid cholesteatoma were released in the study period on a total of 273 patients, with a mean age of 41.2 years. All patients were followed for an average period of 55.3 months. 54% of patients underwent M2c mastoidectomy (Canal Wall Down, CWD), while the remaining underwent Canal Wall Up (CWU) procedures, being M1b2a mastoidectomy the most common one (33%). Mean pre-operative and post-operative ABGs were 29.2 and 23.5 dB, with a significant improvement (p < 0.0001). ‘Mastoidectomy’ and ‘Ossicular reconstruction’ parameters of SAMEO-ATO showed significant association with postoperative ABG, with smaller residual gaps for the classes Mx and On, and worse hearing results for M3a and Ox. Conclusion Our results show the utility of SAMEO-ATO framework, and in particular of ‘M’ (Mastoidectomy) and ‘O’ (Ossicular reconstruction) parameters, in predicting the hearing outcome.

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