Efficacy of Tympanoplasty Without Mastoidectomy for Chronic Suppurative Otitis Media

Webb, Benjamin D.; Chang, Chandong

doi:10.1001/archotol.134.11.1155

Cited by 50 publications

(40 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…reported that tympanosclerosis and ossicle pathologies (fixation, adhesion, erosion) are found in 29.5% on the first surgery and in 63.4% on revision. Hypertrophic or wet look of the middle ear mucosa should raise suspicion of active inflammation, secretory middle ear, or Eustachian tube dysfunction [17,18] . These findings may decrease the success rates of revision tympanoplasty.…”

Section: Discussionmentioning

confidence: 99%

Factors Affecting Success and Results of Cartilage-Perichondrium Island Graft in Revision Tympanoplasty

Şahan¹,

Derin²,

Deveer³

et al. 2014

Int Adv Otol

View full text Add to dashboard Cite

OBJECTIVE:The chance of complete postoperative healing of the tympanic membrane is relatively low due to poor blood supply of the graft in patients who undergo revision tympanoplasty. The aim of this study is to assess postoperative healing and the factors affecting closure of the tympanic membrane and hearing gain after revision tympanoplasty with cartilage-perichondrium island graft. MATERIALS and METHODS:This study was conducted as a retrospective review of charts of patients who underwent revision tympanoplasty with composite cartilage-perichondrium island graft at our clinic. Patients who underwent radical or modified radical mastoidectomy for the treatment of cholesteatoma and who had stapes fixation were excluded. All grafts were placed using over-under technique. Ossiculoplasty and mastoidectomy were performed as needed. Closure of the tympanic membrane and hearing thresholds were evaluated at the end of postoperative year 1. RESULTS:Thirty-three cases, 14 females and 19 males with mean age 37.5±12.7, were included in the study. Ossiculoplasty was performed in 8 cases, and mastoidectomy was added to tympanoplasty in 12 cases. Tympanic membrane was intact in 29 cases (87.4%) in the 12th postoperative month. Large perforation, adhesive tympanic membrane, and especially hypertrophic middle ear mucosa were found to have negative impact on success of graft (p<0.01). The success of graft in patients with mastoidectomy was lower than without mastoidectomy (p<0.001). Age (p=0.491), gender (p=0.567), surgical approach (p=0.378), and the number of operations (p=0.283) did not contribute to the success of the graft. Average improvement of postoperative air conduction hearing threshold was 13.2±5.5 dB, and average decrease in air bone gap was 11.7±5.5 dB. CONCLUSION:Postoperative closure rate of the tympanic membrane was high and audiologic improvement was satisfactory with cartilage-perichondrium island graft in revision tympanoplasty. Cartilage-perichondrium island graft may be preferred for reconstruction of the tympanic membrane because of its resistance to inflammation and poor feeding in revision tympanoplasty.

show abstract

Section: Discussionmentioning

confidence: 99%

Factors Affecting Success and Results of Cartilage-Perichondrium Island Graft in Revision Tympanoplasty

Şahan¹,

Derin²,

Deveer³

et al. 2014

Int Adv Otol

View full text Add to dashboard Cite

show abstract

“…[9] Sheehy recommended simple cortical mastoidectomy in all tympanoplasty operations as a routine procedure. [3] Tos also recommended mastoidectomy for draining ears, but also indicated that they could not always achieve improved outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…[5][6][7] Besides, some authors are against mastoidectomy in both dry and suppurative COM without cholesteatoma. [8,9] In this study, we have retrospectively investigated the patients diagnosed as chronic otitis media without cholesteatomas, but with radiologically detected sclerotic mastoid who had undergone tympanoplasty without mastoidectomy. We have tried to compare pre-and postoperative anatomic and functional outcomes.…”

mentioning

confidence: 99%

Tympanoplasty type 1 in the treatment of patients with sclerotic mastoid: anatomical and functional results

Dündar¹,

Soy²,

Kulduk³

et al. 2014

J Med Updates

View full text Add to dashboard Cite

“…Abgesehen davon, dass bei dieser Theorie Zusatzannahmen nötig sind -das vergrößer-te Volumen darf natürlich nicht mit einer gleichzeitigen Vergrößerung der resorbierenden Schleimhautoberfläche einhergehen -hat sich das Konzept nicht durchsetzen können. Heute wird eine Routinemastoidektomie in solchen Fällen nicht als nö-tig angesehen [70,71,72], es sei denn, andere Gründe (Entzündungen, chronische Sekretion, Granulationen, Cholesteatom usw.) würden für eine Mastoidrevision sprechen.…”

Section: Mittelohrchirurgieunclassified

Eustachian tube and middle ear mechanics

Pau

2011

HNO

View full text Add to dashboard Cite

Even the most sophisticated prostheses for reconstruction of the ossicular chain do not work in the presence of Eustachian tube dysfunction. This review gives an update on the mechanisms of middle ear pressure regulation and middle ear ventilation, as well as methods for measuring the opening and closing function of the Eustachian tube. So far, in most tube function tests pressures are applied far beyond the physiological range in order to open the tube or force it to open. New methods like sonotubometry with perfect sequences (PSEQ) or the application of pressure in the nasopharynx with the Estève technique seem very promising. However, these measurements only provide snapshots of tube function. Presently, new tests are being developed for long-term measurements even in cases with perforated tympanic membranes. Attempts to improve impaired tube function have recently included laser surgery and balloon tuboplasty, yielding positive long-term results requiring verification in larger controlled studies. Eustachian tube dysfunction does not only mean blockage but can also include abnormal patencies of the Eustachian tube, for which new approaches are discussed here. In the case of suspected tube dysfunction, cartilage should be used to avoid early tympanic retraction or recurrent perforation; external ventilation using ventilation tubes should be considered.

show abstract

Efficacy of Tympanoplasty Without Mastoidectomy for Chronic Suppurative Otitis Media

Abstract: To compare the efficacy of tympanoplasty without mastoidectomy in patients with chronic suppurative otitis media (CSOM) vs efficacy in those with dry tympanic membrane (TM) perforations.Design: Retrospective controlled study based on a prospective database.

Cited by 50 publications

References 9 publications

Factors Affecting Success and Results of Cartilage-Perichondrium Island Graft in Revision Tympanoplasty

Factors Affecting Success and Results of Cartilage-Perichondrium Island Graft in Revision Tympanoplasty

Tympanoplasty type 1 in the treatment of patients with sclerotic mastoid: anatomical and functional results

Eustachian tube and middle ear mechanics

Contact Info

Product

Resources

About