Mastoidektomi Revisi pada Otitis Media Supuratif Kronik Tipe Bahaya

Abstrak Operasi mastoid berkembang sebagai penanganan terhadap Otitis Media Supuratif Kronik (OMSK). Mastoidektomi revisi dilakukan bila tujuan operasi pertama tidak tercapai. Kegagalan operasi mastoid bisa disebabkan oleh berbagai hal, diantaranya penanganan air cell yang tidak adekuat, facial ridge yang tinggi, kegagalan membuang semua kolesteatom, meatoplasti yang tidak adekuat dan ketidakpatuhan pasien untuk kontrol setelah operasi. Operasi mastoid revisi biasanya lebih sulit dan berbahaya karena anatomi telinga tengah menjadi tidak jelas, landmark dapat hilang dan struktur berbahaya sudah terpapar. Dilaporkan satu kasus operasi mastoid revisi pada seorang laki-laki berumur 25 tahun, yang ditatalaksana dengan timpanomastoidektomi dinding runtuh.Kata kunci: otitis media supuratif kronik, mastoidektomi revisi, kolesteatom, meatoplasti Abstract Surgery of the mastoid developed as a treatment for chronic suppurative otitis media. Revision mastoid surgery done if the aim of first surgery not achieved. Failure of mastoid operation may caused by many things, including handling of air cells are not adequate, high facial ridge, failure to remove all cholestetoma meatoplasty in adequate and non adherence of patient to control after surgery. Revision mastoid surgery is usually more difficult and dangerous, because anatomy of the middle ear may be altered, some of the important landmarks can be loss and dangerous structure has been exposed. It was reported one case revision mastoid surgery in a man aged 25 years old, management with canal wall down tympanomastoidectomy.Keywords: chronic suppurative otitis media, revision mastoidectomy, cholesteatoma, meatoplasty

The use of rigid endoscopes in cholesteatoma surgery

The 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.

Mastoidectomy for chronic serous otitis media

The purpose of this paper is to show that satisfactory results following mastoidectomy can be obtained for the problem of chronic serous otitis. The success of the simple mastoid operation or mastoidectomy with facial recess approach and the subsequent increased aeration of the mastoidantral-attic-middle-ear complex is to be suggested when the repeated use of myringotomy tubes alone is not the answer to chronic serous otitis. It is chronic negative pressure due to eustachian tube dysfunction that leads to irreversible mastoid disease.Seven cases of mastoidectomy for chronic serous otitis media are presented. All cases had adequate conservative medical and surgical treatment over a period of years for chronic serous otitis before mastoidectomy was considered. The clinical history, as well as lateral mastoid X-ray, was used in diagnosing irreversible mastoid disease.