Long-term follow-up evaluation of mastoidectomy in children with non-cholesteatomatous chronic suppurative otitis media.
OBJECTIVE
In spite of declining prevalence chronic suppurative otitis media without cholesteatoma (CSOM) still poses a significant health problem. Randomized clinical trials comparing medical and surgical intervention are not available. Hence, the treatment of CSOM is almost exclusively based on empirical experience. The purpose of the present study was to evaluate the long-term effects of mastoidectomy combined with myringotomy and exploration of the middle ear in children with CSOM.


METHODS
47 children with CSOM underwent surgery including mastoidectomy. Ear status was investigated peri-operatively and at a long-term follow-up (5-21 years post-operatively).


METHODS
Final success rate, FS (dry ears for several years) and the optimal final success rate, OFS (dry ears for several years without re-operations and without retractions/perforations) were estimated.


RESULTS
No serious surgical complications occurred. Post-operatively re-mastoidectomy was performed in 13% and re-myringoplasty/tympanoplasty in 21%. At the long-term follow-up the FS rate was 94% and the OFS rate was 61%.


CONCLUSIONS
Surgery alone did not entirely cure CSOM which may justify randomized studies comparing conservative treatment and myringoplasty with/without mastoidectomy. Finally, mastoidectomy in these patients must be considered as a last resort when intense conservative treatment fails.
Rickers
Jonas
J
ENT Department, Aarhus University Hospital, DK-8000 Aarhus C, Denmark. jrickers@dadlnet.dk
Petersen
Claus Gregers
CG
Pedersen
Christian Brahe
CB
Ovesen
Therese
T
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003718:Denmark; D005260:Female; D005500:Follow-Up Studies; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D008297:Male; D008416:Mastoid / Q000601:surgery*; D009225:Myringoplasty; D010035:Otitis Media, Suppurative / Q000150:complications* / Q000503:physiopathology / Q000601:surgery*; D018058:Tympanic Membrane Perforation / Q000601:surgery