scholarly journals Surgical Outcomes of Revision Operation for Non-Cholesteatomatous Chronic Otitis Media

2021 ◽  
Vol 64 (5) ◽  
pp. 304-309
Author(s):  
Juho Han ◽  
Jisoo Lee ◽  
Sung Kwang Hong ◽  
Hyo Jeong Lee ◽  
Hyung-Jong Kim
Keyword(s):  
Otitis Media ◽  
Surgical Outcomes ◽  
Chronic Otitis Media ◽  
Surgical Approaches ◽  
Middle Ear Surgery ◽  
Canal Wall ◽  
Revision Operation ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy ◽  
Better Than

Background and Objectives The aim of this study was to investigate the surgical outcomes of revision operation due to recurrence of non-cholesteatomatous chronic otitis media (COM) surgery cases.Subjects and Method From 1989 to 2018, 5197 cases of COM surgery were performed at Kangdong and Hallym University Sacred Heart Hospital. Among them, clinical data of 297 subjects who had undergone revision tympanoplasty and/or mastoidectomy for recurrent noncholesteatomatous COM were retrospectively collected from computerized database of middle ear surgery (Korean Otological Society program 2005). Each case was categorized by surgical approaches into canal wall down mastoidectomy (CWDM), canal wall up mastoidectomy (CWUM), or tympanoplasty only groups.Results Tympanoplasty only was performed in 170 cases, CWDM in 74 cases, and CMUM in 53 cases. Postoperative perforation occurred in 9.4% of total cases, and less frequently in CMDM compared with tympanoplasty only (<i>p</i>=0.023), and CMUM (<i>p</i>=0.049), respectively, whereas no differences between tympanoplasty only and CMUM (<i>p</i>=0.930) were found. Postoperative infection rate was 1.0% and did not show any differences among the groups. Postoperative successful hearing was obtained in 66.7% of total cases, and the success rate of tympanoplasty only was better than that of CMDM (<i>p</i>=0.001), and CMUM (<i>p</i>=0.011). And, that of CMUM was better than that of CMDM (<i>p</i>=0.011).Conclusion The results showed that postoperative perforation occurred less frequently in CMDM than in tympanoplasty only and in CWUM; successful hearing was achieved more frequently in tympanoplasty alone than in the other surgical approaches in recurrent non-cholesteatomatous COM.

scholarly journals Extradimension of fasciocutaneous flap in the surgical management of postaural fistula, a complication of chronic otitis media – squamous type

2017 ◽  
Vol 3 (2) ◽  
pp. 419
Author(s):  
Madhubari Vathulya ◽  
Manu Malhotra ◽  
Saurabh Varshney
Keyword(s):  
Otitis Media ◽  
Surgical Techniques ◽  
Chronic Otitis Media ◽  
Neck Region ◽  
Fasciocutaneous Flap ◽  
Mastoid Cavity ◽  
Canal Wall ◽  
Tertiary Referral ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy

<p>Post aural fistula is one of the complications of squamous variety of chronic otitis media (COM-S). For decades together a lot of new surgical techniques have been introduced in the treatment of COM-S out of which canal wall down mastoidectomy is most commonly practised. Despite these efforts many patients presenting with COM-S end up in tertiary referral centers at a late stage with complications like fistulas and by this time a number of procedures have already been done on them. A 19 year old female presents with Postaural fistula as a complication of COM- S type. Due to the local scarring, newer flap options needed to be sought to obliterate the mastoid cavity. This article demonstrates the extra dimension for the usage of fasciocutaneous flap from neck region to treat patients of recurrent postaural fistula.</p>

Hearing Status After Cartilage Augmented Type III Tympanoplasty: In Chronic Otitis Media Squamous Type

2021 ◽  
Vol 18 (2) ◽  
pp. 27-30
Author(s):  
Lok Ram Verma ◽  
Dhundi Raj Paudel
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Effective Area ◽  
Canal Wall ◽  
Hearing Improvement ◽  
Type Iii ◽  
Hearing Status ◽  
Fascia Graft ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy

Introduction: Tympanoplasty is typically performed in conjunction with a canal wall down mastoidectomy in patient with Chronic Otitis Media Squamous. The results from experimental and clinical studies of the type III stapes columellar reconstruction have shown that interposing a disk of cartilage between the graft and the stapes head improves hearing in the lower frequencies by 5 to 10 dB. They hypothesize that the cartilage acts to increase the “effective” area of the graft that is coupled to the stapes, which leads to an increase in the middle ear gain of the reconstructed ear. Aims: To assess the hearing improvement after cartilage augmented Type III Tympanoplasty in chronic otitis media squamous disease. Methods: This study was conducted in 44 patients with Chronic Otitis Media squamous in the patients attending the department of Otorhinolaryngology in NGMC teaching hospital from November 2018 to March 2020. Canal Wall Down mastoidectomy with cartilage augmented type III Tympanoplasty and was done. Augmentation was done with thin 3-4 mm conchal cartilage interposed between stapes and Temporalis fascia graft. Results: There were 11(25%) male and 33(75%) female, with mean age of 29.48 years, ranging from minimum of 15 years to maximum 56 years. The preoperative mean A–B gap was 21.82 and postoperatively means AB gap was 12.20 dB with overall AB gap gain was 9.64 dB. Conclusion: Significant hearing improvement is seen in Canal Wall Down mastoidectomy Chronic Otitis Media squamous after cartilage augmented type III tympanoplasty.

scholarly journals Comparison of Pre and Post-operative Hearing Results in Canal Wall Down Mastoidectomy with Type III Tympanoplasty

2008 ◽  
Vol 47 (172) ◽  
Author(s):  
Bikash Lal Shrestha ◽  
CL Bhusal ◽  
H Bhattarai
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Chronic Otitis Media ◽  
Classical Type ◽  
Canal Wall ◽  
Hearing Results ◽  
Type Iii ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy

This study was done to compare the pre and post-operative hearing results in patients undergoingcanal wall down mastoidectomy with classical type III tympanoplasty using temporalis fasciaalone.Patients of ≥5 years age with the diagnosis of Chronic otitis media (squamous) with conductive ormixed hearing loss, needing canal wall down mastoidectomy and with intact and mobile stapessuprastructure at surgery who underwent classical type III tympanoplasty were included in thestudy. The pre and post-operative PTA was performed and evaluated. The post-operative hearingwas assessed in terms of average ABG and size of ABG closure.Mean pre and post-operative air bone gap in classical type III tympanoplasty were 37.8 dB and 29.8dB respectively and these differences were statistically significant. The postoperative PTA-ABGranged from 15-61.2 dB.Hearing results after type III tympanoplasty varied widely showing statistically significantimprovement in mean post-operative PTA-ABG but there was a great variation.Key words: air bone gap, chronic otitis media, mastoidectomy, tympanoplasty

scholarly journals Four layers reconstruction of the posterior ear canal wall in one stage surgery

2021 ◽  
Author(s):  
Khaled M. Mokbel Khalefa
Keyword(s):  
Otitis Media ◽  
Recurrent Infection ◽  
Posterior Wall ◽  
Chronic Suppurative Otitis Media ◽  
Canal Wall ◽  
Suppurative Otitis Media ◽  
Posterior Canal ◽  
One Stage ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy

<p class="abstract"><strong>Background:</strong> Canal wall down mastoidectomy are still practiced in cases of chronic suppurative otitis media with cholesteatoma to ensure complete disease removal. The resulting cavity is prone to recurrent infection, chronic discharge and frequent care. Reconstruction of the posterior canal wall should be planned by the surgeon. Various techniques for external auditory canal (EAC) reconstruction have been recommended to eliminate open cavity problems. The surgeon should choose the type of grafts either autologous, homografts or synthetic materials. Furthermore, the surgeon should decide whether to do the reconstruction either immediate in the first stage of surgery or delayed as a second stage.</p><p class="abstract"><strong>Methods:</strong> In this study, the ridge was reconstructed at the same time of mastoidectomy by autologous tissues. The presenting study reconstructed the posterior canal wall in four layers; skin, perichondrial flap, cartilage and periosteal flap in that order from the meatal side to the mastoid side. The presenting study included 48 patients (32 males and 16 females) with age ranged from 18-55 and 20-50 years. All included patients were presented at the outpatient clinic with unilateral chronic suppurative otitis media with persistent discharge. They had been operated at our tertiary hospital between January. 2012 to March 2014.</p><p class="abstract"><strong>Results:</strong> Successful reconstruction was obtained in all cases, with no dehiscence or necrosis.</p><p class="abstract"><strong>Conclusions:</strong> The reconstruction of the posterior wall by the four layers technique was successful and efficient. It is recommended to do this repair concomitantly with canal wall down mastoidectomy as one stage surgery.</p>

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.

scholarly journals Repair of Temporal Bone Encephalocele following Canal Wall Down Mastoidectomy

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Sarantis Blioskas ◽  
Ioannis Magras ◽  
Stavros Polyzoidis ◽  
Konstantinos Kouskouras ◽  
Georgios Psillas ◽  
...  
Keyword(s):  
Temporal Bone ◽  
Chronic Otitis Media ◽  
Base Deficit ◽  
Layer By Layer ◽  
Canal Wall ◽  
Temporalis Fascia ◽  
Dural Graft ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy

We report a rare case of a temporal bone encephalocele after a canal wall down mastoidectomy performed to treat chronic otitis media with cholesteatoma. The patient was treated successfully via an intracranial approach. An enhanced layer-by-layer repair of the encephalocele and skull base deficit was achieved from intradurally to extradurally, using temporalis fascia, nasal septum cartilage, and artificial dural graft. After a 22-month follow-up period the patient remains symptom free and no recurrence is noted.

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.

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.

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