Tympanomastoidectomy for chronic otitis media without cholesteatoma.
A series of 221 ears with chronic suppurative otitis media without cholesteatoma is presented--84% of the cases were treated using one-stage tympanomastoidectomy and 15% underwent cortical mastoidectomy with planned second-stage tympanoplasty. Mean follow-up period was 6.3 years. Control of infection succeeded in 92% after the primary operation. Failures were most common in ears infected with Pseudomonas aeruginosa. Postoperative cholesteatoma developed in 5 ears (2.2%). Hearing results were unsatisfactory; a postoperative air-bone gap within 20 dB was achieved in only 62%. In revision operations, retained mastoid air cells were found in 64% of ears with recurrent or persistent discharge. Thirty-seven percent of patients with unsuccessful outcome were observed to have a possible underlying or concomitant disease. The importance of intensive preoperative conservative treatment and careful surgical technique is stressed.
Vartiainen
E
E
Department of Otolaryngology, University of Kuopio, Finland.
Kansanen
M
M
D000293:Adolescent; D000328:Adult; D002648:Child; D002781:Cholesteatoma / Q000601:surgery; D002908:Chronic Disease; D005500:Follow-Up Studies; D006801:Humans; D008416:Mastoid / Q000601:surgery*; D008875:Middle Aged; D010035:Otitis Media, Suppurative / Q000382:microbiology / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications; D011552:Pseudomonas Infections; D012008:Recurrence; D012086:Reoperation; D013203:Staphylococcal Infections; D014432:Tympanic Membrane / Q000601:surgery*