title: Management of chronic otitis media by subtotal petrosectomy.
abstract: OBJECTIVE
  Subtotal petrosectomy is the complete exenteration of all air cell tracts of the temporal bone. The isthmus of the Eustachian tube is obliterated and the external auditory canal is closed. The aim of this study was to describe the use of this technique in the management of certain cases of chronic otitis media.
  
  
  METHODS
  We conducted a retrospective revision of the patients treated in our Institution with this technique for chronic otitis media in a 5-year period (2008-2012). All charts were reviewed and data from the otomicroscopy, audiometry, radiology, surgical findings, postoperative complications and follow-up (including diffusion magnetic resonance imaging, MRI) of a minimum of 24 months were collected.
  
  
  RESULTS
  In this period petrosectomy was performed on 28 patients for chronic otitis media. We treated 13 cases as primary cases, while 15 cases were secondary (patients that had already undergone another procedure in that ear). Fifteen cases had no serviceable hearing. Only 1 case had an immediate postoperative complication (infection); during the posterior follow-up, 2 cases had to be reoperated for diffusion restriction in the mastoid area revealed in the MRI 2 years after surgery.
  
  
  CONCLUSIONS
  A subtotal petrosectomy is rarely performed for the treatment of chronic otitis media. However, it is a technique that we have to keep in mind for the treatment of certain cases where there is recurrence and deep hearing loss, as well as in cases with good cochlear reserve if the disease coexists with other complications.
authors.affiliation: Servicio de Otorrinolaringología, Hospital Universitario Donostia, San Sebastián, España. Electronic address: xaltuna@osakidetza.net.
authors.forename: Xabier
authors.initials: X
authors.lastname: Altuna
authors.affiliation: Servicio de Otorrinolaringología, Hospital Universitario Donostia, San Sebastián, España.
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Navarro
authors.affiliation: Servicio de Otorrinolaringología, Hospital Universitario Donostia, San Sebastián, España.
authors.forename: Miren
authors.initials: M
authors.lastname: Goiburu
authors.affiliation: Servicio de Otorrinolaringología, Hospital Universitario Donostia, San Sebastián, España.
authors.forename: Idoia
authors.initials: I
authors.lastname: Palicio
mesh_terms: D002781:Cholesteatoma / Q000150:complications; D002908:Chronic Disease; D003638:Deafness / Q000209:etiology; D004424:Ear Canal / Q000601:surgery; D005064:Eustachian Tube / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D010027:Osteotomy / Q000379:methods*; D010033:Otitis Media / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D010579:Petrous Bone / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology
keywords: Cholesteatoma; Complicaciones; Complications; Hueso petroso, cirugía; Otitis media; Petrous bone, surgery; colesteatoma