Hostname: page-component-cd9895bd7-p9bg8 Total loading time: 0 Render date: 2024-12-23T20:10:13.539Z Has data issue: false hasContentIssue false
  • English
  • Français

Endoscopic epitympanic exploration in mucosal chronic otitis media: is canal wall up mastoidectomy really needed?

Published online by Cambridge University Press:  25 January 2021

A Das ,
S Mitra ,
S Hazra  and
A Sengupta
A Das
Affiliation:
Institute of Post-Graduate Medical Education and Research (‘IPGMER’) and Seth Sukhlal Karnani Memorial (‘SSKM’) Hospital, Kolkata, India
S Mitra*
Affiliation:
Institute of Post-Graduate Medical Education and Research (‘IPGMER’) and Seth Sukhlal Karnani Memorial (‘SSKM’) Hospital, Kolkata, India
S Hazra
Affiliation:
Institute of Post-Graduate Medical Education and Research (‘IPGMER’) and Seth Sukhlal Karnani Memorial (‘SSKM’) Hospital, Kolkata, India
A Sengupta
Affiliation:
Institute of Post-Graduate Medical Education and Research (‘IPGMER’) and Seth Sukhlal Karnani Memorial (‘SSKM’) Hospital, Kolkata, India
*
Author for correspondence: Dr Sandipta Mitra, Institute of Post-Graduate Medical Education and Research (‘IPGMER’) and Seth Sukhlal Karnani Memorial (‘SSKM’) Hospital, 244 AJC Bose Road, Kolkata700020, India E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

To compare endoscopic epitympanic exploration with conventional canal wall up (cortical) mastoidectomy for mucosal chronic otitis media in terms of post-operative outcomes.

Methods

Seventy-six patients diagnosed with chronic otitis media (mucosal variety) were randomly assigned to two treatment groups: endoscopic epitympanic exploration and conventional canal wall up (cortical) mastoidectomy. The groups were compared in terms of: post-operative anatomical outcomes (graft uptake), middle-ear physiological outcomes (post-operative tympanometry), audiological outcomes (air–bone gap), surgical time, post-operative pain, vertigo, and long-term complications such as retraction pocket and re-perforation.

Results

There was a statistically significant difference between the groups in terms of mean air–bone gap at 12 months, surgical time, and median post-operative pain measured at 6 hours (p < 0.05). No statistically significant differences were noted in terms of: graft uptake at 1, 3 and 6 months, mean air–bone gap at 3 and 6 months, tympanometry at 3, 6 and 12 months, vertigo at 1 week, or long-term complications.

Conclusion

Endoscopic epitympanic exploration resulted in significantly better long-term audiological outcomes, shorter operating time and less pain compared with conventional canal wall up (cortical) mastoidectomy.

Keywords

Endoscopic Surgical ProcedureMastoidectomy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 135 , Issue 1 , January 2021 , pp. 39 - 44
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Dr S Mitra takes responsibility for the integrity of the content of the paper

References

Trinidade, A, Page, JC, Dornhoffer, JL. Therapeutic mastoidectomy in the management of noncholesteatomatous chronic otitis media: literature review and cost analysis. Otolaryngol Head Neck Surg 2016;155:914–22CrossRefGoogle ScholarPubMed
Marchioni, D, Mattioli, F, Alicandri-Ciufelli, M, Presutti, L. Prevalence of ventilation blockages in patients affected by attic pathology: a case-control study. Laryngoscope 2013;123:2845–53CrossRefGoogle ScholarPubMed
Marchioni, D, Molteni, G, Presutti, L. Endoscopic anatomy of the middle ear. Indian J Otolaryngol Head Neck Surg 2011;63:101–13CrossRefGoogle ScholarPubMed
Marchioni, D, Alicandri-Ciufelli, M, Molteni, G, Artioli, FL, Genovese, E, Presutti, L. Selective epitympanic dysventilation syndrome. Laryngoscope 2010;120:1028–33Google ScholarPubMed
Tarabichi, M. Endoscopic management of limited attic cholesteatoma. Laryngoscope 2004;114:1157–62CrossRefGoogle ScholarPubMed
Kapadiya, M, Tarabichi, M. An overview of endoscopic ear surgery in 2018. Laryngoscope Investig Otolaryngol 2019;4:365–73CrossRefGoogle ScholarPubMed
Cinamon, U, Sadé, J. Mastoid and tympanic membrane as pressure buffers: a quantitative study in a middle ear cleft model. Otol Neurotol 2003;24:839–42CrossRefGoogle Scholar
Takahashi, H, Honjo, I, Naito, Y, Miura, M, Tanabe, M, Hasebe, S et al. Gas exchange function through the mastoid mucosa in ears after surgery. Laryngoscope 1997;107:1117–21CrossRefGoogle ScholarPubMed
Huang, J, Li, Z, Wu, K, Wang, W. Long-term outcomes after performing tympanoplasty without mastoidectomy for active and inactive noncholesteatomatous chronic otitis media. ORL J Otorhinolaryngol Relat Spec 2018;80:277–83CrossRefGoogle ScholarPubMed
Bhat, KV, Naseeruddin, K, Nagalotimath, US, Kumar, PR, Hegde, JS. Cortical mastoidectomy in quiescent, tubotympanic, chronic otitis media: is it routinely necessary? J Laryngol Otol 2009;123:383–90CrossRefGoogle ScholarPubMed
He, D, Shou, Z, Hsieh, Y, Wang, C, Wang, J, Han, Z et al. Endoscopic tympanoplasty without mastoidectomy for active mucosal chronic otitis media with mastoid and tympanic antrum lesions: a prospective clinical study. ORL J Otorhinolaryngol Relat Spec 2019;81:287–93CrossRefGoogle ScholarPubMed