Significance of intraoperative findings in revision tympanomastoidectomy

Scientific paper - Original scientific paper

• Author: Andro Košec
• Author: Iva Kelava
• Author: Jakov Ajduk
• Author: Mihael Ries
• Author: Robert Trotić
• Author: Vladimir Bedeković
• Author's institution: University of Zagreb; School of Medicine
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences

Abstract (english)

PURPOSE:
The study was designed to assess correlations between intraoperative findings in revision tympanomastoidectomy as predictors of cholesteatoma recurrence. -----
MATERIALS AND METHODS:
A retrospective single-institution cohort of 101 patients who underwent surgical treatment for recurrent chronic otitis media in a tertiary referral otology centre. -----
RESULTS:

Out of 101 patients, 65 had canal wall up and 36 canal wall down revision surgery. There were 35 cholesteatoma recurrences. Sites most commonly associated with recurrent disease were residual facial ridge cells in 46 (45.5%), ossicular chain sites in 46 (45.5%) patients, posterior external auditory canal wall erosions in 38 (37.6%) patients and mastoid apex recurrence in 35 (34.7%) patients. Ossicular and posterior external auditory canal wall erosion and incomplete removal of mastoid apex cells correlate well with cholesteatoma recurrence accompanied by canal wall up surgery (p=0.009). Residual mastoid apex cells, posterior external auditory canal wall erosion and presence of residual facial ridge cells were identified as the strongest positive predictors of cholesteatoma recurrence, identifying high risk patients associated with canal wall down procedures (p=0.0036). -----

CONCLUSIONS:

Correlations between intraoperative findings and cholesteatoma recurrence could improve preoperative and intraoperative planning and reduce the rates of postoperative failures1 due to mismanagement of high risk areas.

• Keywords (english): Adolescent; Adult; Aged; Aged, 80 and over; Child; Cholesteatoma, Middle Ear/diagnosis; Cholesteatoma, Middle Ear/epidemiology; Cholesteatoma, Middle Ear/surgery; Chronic Disease; Female; Humans; Longitudinal Studies; Male; Mastoidectomy; Middle Aged; Otitis Media/etiology; Otitis Media/pathology; Otitis Media/surgery; Recurrence; Reoperation; Retrospective Studies; Tympanoplasty; Young Adult
• Language: english
• Publication type: Scientific paper - Original scientific paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Accepted version
• Journal title: American Journal of Otolaryngology
• Numbering: vol. 38, no. 4, pp. 462-465
• p-ISSN: 0196-0709
• DOI: https://doi.org/10.1016/j.amjoto.2017.04.006
• URN:NBN: urn:nbn:hr:105:666065
• Publication: 2017-07
• Document URL: https://doi.org/10.1016/j.amjoto.2017.04.006
• Type of resource: Text
• Access conditions: Open access
• Created on: 2024-03-28 09:17:50