Efficacy of mastoidectomy on MRSA-infected chronic otitis media with tympanic membrane perforation.
OBJECTIVE
To retrospectively evaluate the efficacy of mastoidectomy on methicillin-resistant Staphylococcus aureus (MRSA)-infected chronic otitis media in comparison with methicillin-susceptible Staphylococcus aureus (MSSA)-infected otitis media.


METHODS
Between January 1998 and October 2003, 18 ears underwent surgery for MRSA-infected chronic otitis media with tympanic membrane perforation at the Department of Otolaryngology, Hyogo College of Medicine. Another 33 ears underwent surgery for MSSA-infected chronic otitis media with tympanic membrane perforation during the same period. The postoperative results of graft success rate, hearing results and other complications were compared between MRSA-infected and MSSA-infected ears with or without mastoidectomy, and discharging or dry ears.


RESULTS
In MRSA, the mastoidectomy group tended to have a better graft success rate than the non-mastoidectomy group. In MSSA, there were almost the same graft success rate and hearing results between the mastoidectomy and non-mastoidectomy groups regardless of the presence of discharge. In MRSA-infected discharging ears, the rate of postoperative complications (ear drum perforation, persistent otorrhea, and dehiscence of skin incision) were significantly lower in the mastoidectomy group than in the non-mastoidectomy group (p=0.046).


CONCLUSIONS
Mastoidectomy had significantly better results concerning postoperative complications in discharging ears with MRSA-infected chronic otitis media. We recommend performing tympanoplasty with mastoidectomy in MRSA-infected chronic otitis media.
Mutoh
Toshihiko
T
Department of Otolaryngology, Hyogo College of Medicine, 1-1 Mukogawa, Nishinomiya City, Hyogo 663-8501, Japan. mutochin@hyo-med.ac.jp
Adachi
Osamu
O
Tsuji
Kojiro
K
Okunaka
Mieko
M
Sakagami
Masafumi
M
D000293:Adolescent; D000328:Adult; D002648:Child; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008416:Mastoid / Q000601:surgery*; D016106:Methicillin Resistance; D008875:Middle Aged; D010033:Otitis Media / Q000150:complications* / Q000382:microbiology*; D013506:Otologic Surgical Procedures / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000150:complications* / Q000382:microbiology*; D016896:Treatment Outcome; D018058:Tympanic Membrane Perforation / Q000150:complications* / Q000601:surgery*