title: Tympanomastoidectomy: planned second-look tympanotomy.
abstract: OBJECTIVE
  To review the outcome following surgery for cholesteatoma/retraction pocket disease where second-look tympanotomy was recommended for selected patients.
  
  
  METHODS
  Retrospective outcome analysis following canal wall down mastoid surgery for cholesteatoma/retraction pocket disease.
  
  
  METHODS
  The study included 158 patients (163 ears) operated on between 1993 and 2003. Data were collected on the recommendation for second-look tympanotomy, the findings at second-look tympanotomy, and hearing threshold.
  
  
  RESULTS
  Second-look tympanotomy was recommended for 36 patients, 32 had surgery, and 30 were free of residual disease. The respective mean pre- and postoperative bone conduction threshold was 8.9 dB and 18 dB for single-stage surgery and 15.8 dB and 16.8 dB for second-look tympanotomy. The mean preoperative air-bone gap (0.5, 1, 2, 4 kHz) was 27.1 dB for single-stage surgery and 27.9 dB for staged surgery. The 1-year air-bone gap was 24.6 dB and 28.6 dB, respectively.
  
  
  CONCLUSIONS
  Planned second-look tympanotomy demonstrated excellent early disease control and allowed management of the middle ear pathology.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Department of Medical and Surgical Sciences, Medical School, University of Otago, Dunedin, New Zealand. patrickd@healthotago.co.nz
authors.forename: Patrick J D
authors.initials: PJ
authors.lastname: Dawes
authors.forename: Mohannad
authors.initials: M
authors.lastname: Al-Qudah
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001309:Auditory Threshold; D001844:Bone Conduction / Q000502:physiology; D002675:Child, Preschool; D018424:Cholesteatoma, Middle Ear / Q000601:surgery*; D004432:Ear, Middle / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008416:Mastoid / Q000601:surgery*; D008875:Middle Aged; D013506:Otologic Surgical Procedures / Q000379:methods*; D012189:Retrospective Studies; D024162:Second-Look Surgery / Q000379:methods*; D014432:Tympanic Membrane / Q000601:surgery*; D055815:Young Adult