[Intact-bridge tympanomastoidectomy procedure: a reasonable option in the surgery of chronic otitis media and mastoiditis with cholesteatoma and/or granulation tissue].
OBJECTIVE
To study and evaluate a surgical option for the treatment of otitis media and mastoiditis with cholesteatoma and/or granulation tissue.


METHODS
The procedure is called intact-bridge tympanomastoidectomy (IBM). There are some modifications for the treatment of patients suffered from chronic otitis media and mastoiditis with cholesteatoma and/or granulation tissue. The features of IBM include: 1. the aditus, mastoid and attic opened and the intractable pathological tissues eradicated thoroughly. 2. the posterior tympanal space opened through the facial recess if necessary. 3. a widened middle ear space by lowering bony bridge established. 4. the adults blocked. 5. immediate or staging tympanoplasties conducted according to the conditions of mucosa in the tympanum.


RESULTS
The modified IBM procedure was performed on 62 ears from 61 cases. The follow-up has been 12-38 months and more than two years in 51 ears. The dry ear was obtained within 5-13 weeks with an average of 6 weeks. In 24.2% of ears the air-bone gap(ABG) was 20dB HL or less and within 21-30 dB HL in 41.9% of ears, the ABG over 31 dB HL was 16.1%.


CONCLUSIONS
Our results indicate that IBM procedure fulfills the desired purposes of both open- and close-cavity techniques, the thorough eradication of diseased tissue allow to get a dry ear and restoration of hearing. IBM, therefore, is a reasonable choice for the surgery of otitis media and mastoiditis with cholesteatoma and/or granulation tissue.
Sun
J
J
Center of Otorhinolaryngology PLA, Naval General Hospital, Beijing 100037, China. jjsun85@sina.com.cn
Li
H
H
Liu
Y
Y
Yuan
W
W
Lin
Y
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D018424:Cholesteatoma, Middle Ear / Q000601:surgery*; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008416:Mastoid / Q000601:surgery*; D008417:Mastoiditis / Q000601:surgery*; D008875:Middle Aged; D010035:Otitis Media, Suppurative / Q000601:surgery*; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods; D014433:Tympanoplasty