Long-term outcome of modified radical mastoidectomy

Abstract

The primary aim of treatment of cholesteatoma is to attain a dry, safe, stable ear, free of disease. Maintaining or improving hearing is important but the pursuit of a hearing result should not compromise this primary aim. This study reviews the long-term outcome of 133 patients, suffering from advanced disease, who underwent modified radical mastoidectomy between 1995 and 2000. Of these, 49 per cent had had previous mastoid surgery elsewhere. A dry, waterproof ear was attained in 95 per cent of patients. In 77 per cent of patients, hearing was unchanged or improved. In this period, there were two cases of significant post-operative loss in bone conduction, including one dead ear secondary to suppurative labyrinthitis. There were epithelial pearls on follow up in two per cent. These results indicate that when properly performed, modified radical mastoidectomy provides safe surgical access and clears disease with low recurrence rates while mostly maintaining or improving hearing.

Inside-Out Technique Cholesteatoma Surgery

“…It is astonishing that, irrespective of the surgical technique, a dry nonirritated and well-healed ear site was found in accordance with the literature in 93% in our follow-up (6,7,14), particularly because cholesteatoma ears constitute a focus of longstanding chronic infection, often filled with purulent secretion.…”

“…In the literature, surgical technique is regularly debated, also in having different weighting: some authors primarily pursue the objective of a dry ear with a low rate of recurrence (14,15), whereas others emphasize the importance of functionality, especially in children (7). Various attempts have been made to find a dynamic approach (1,6,10,11,15Y17).…”

Prevalence and Antimicrobial Sensitivity Pattern of Pseudomonas Aeruginosa From Chronic Suppurative Otitis Media (Csom) Cases in a Tertiary Care Hospital of Bihar

“…The ratio of male to female patients was 1.3:1. Analogous conclusion has been made by Chandra & Mishra 9 , Mukherjee P et al and Hossain MM et al 10 They concluded that the predominant burden of the disease in males was due to their outdoor working habits exposing them for contamination and contagion. Wang HM et al 11 De Vos C et al 12 and reported a female preponderance in their study with the prevalence of 57.9% and 57% respectively.…”

Cholesteatoma Growth and Proliferation

“…PTEN is a phosphatase that maintains low levels of phosphatidylinositol (3,4,5)-triphosphate (PIP-3) by conversion to PIP-2. If PTEN fails to maintain this homeostasis, PIP-3 levels increase and activate the Akt/PKB pathway.…”

“…Recurrences are common and many individuals with cholesteatoma undergo multiple operations (3,4). Recurrences, and the need for multiple operations, result in progressively worse hearing deficits and an increased risk of facial nerve paralysis and other complications.…”