Factors affecting recovery of mastoid aeration after ear surgery

Abstract

Fifty-six patients after tympanomastoid surgery were examined to determine recovery of mastoid aeration and various pre- and intraoperative factors such as eustachian tube (ET) function, how the mastoid mucosa had been treated during surgery and whether or not a large silastic sheet had been placed in the middle ear or a ventilation tube used. Mastoid aeration recovery was confirmed by computed tomography in 27 of the 57 cases (47%) within 12 months of surgery. Among the factors examined, preservation of the epitympanic mucosa was found to be most important in mastoid aeration recovery. Use of a large silastic sheet to cover the area from the bony ET and tympanic cavity to epitympanum, aditus ad antrum or antrum was found to be of some help in recovery mastoid aeration after complete resection of the mucosa and mastoid air cells. Preoperative ET function, anterior tympanotomy and use of a ventilation tube did not influence recovery.

Regeneration of Mastoid Air Cells in Clinical Applications by In Situ Tissue Engineering

“…Thus, tympanoplasty and mastoidectomy alone are an imperfect therapy for the treatment of intractable otitis media because they result in the absence of a mastoid air cell system, thereby precluding function. The operated ear is still left with the innate cause of the cholesteatoma or the adhesive otitis media, as well as the pathophysiologic background and therefore the tendency to develop a negative gas balance in the middle ear 9 . When traditional surgical techniques are performed on ears for intractable otitis media, the postoperative course is complicated by an atelectatic condition.…”

“…1). As mentioned above, the failure of pressure regulation in the middle ear is thought to be a possible concern in cases of incurable otitis media 3,8,9 …”

Influence of middle ear mucosal condition on post-tympanoplasty audiologic outcome

“…Restoration of aeration in the tympanic cavity after surgery appears to depend upon whether or not air comes into the tympanic cavity through the adjacent Eustachian tube [17]. The patency of Eustachian tube is obtained from normal condition of middle ear mucosa.…”

Transcanal Endoscopic Antrostomy Hole : Its Utility in Restoring Ventilation Pathway to Epitympanum and Mastoid Antrum During Tympanoplasty

“…A hypothetical comparison between those traditional procedures and the present endoscopic surgical procedure in improving postoperative ventilation to epitympanum and mastoid antrum shows that the present endoscopic procedure is less invasive and more mucosal epithelium preservative then those conventional procedures. Study of Tanabe et al showed that preservation of mastoid mucosa played vital role in recovery of mastoid aeration after surgery 7 .…”