title: Impact of the surgical wound closure technique on the revision surgery rate after subtotal petrosectomy.
abstract: The objective of the study was to examine the impact of the surgical wound closure technique as protection of the obliterated tympanomastoid cavity on the revision surgery rate after subtotal petrosectomy (SP). This is a retrospective case series conducted in a tertiary care referral center. 199 patients (212 ears) with recurrent chronic otitis media underwent SP followed by tympanomastoid obliteration with abdominal fat at a single tertiary referral center between 2005 and 2015. 124 SP were carried out without (group A), 74 with temporalis muscle flap (group B) and 14 with reinforcing material like polydioxanone foil or bovine pericardium or allogenic fascia lata (group C) for wound closure. The evaluated follow-up was either until the scheduled device implantation or 6 months postoperatively. We assessed the rate of postoperative wound healing disorder with revision surgery according to the surgical technique for closure of the obliterated cleft. Revision surgery due to impaired wound healing was necessary in 16 % of the total cases (group A: 18.5 %, group B: 10.8 %, group C: 21.4 %). Further analysis concerning the dehiscent area in both sites (retroauricular and blind sac of the external auditory canal) was conducted and discussed. There was no significant difference observed in the rate of revision surgery between the three groups. The wound healing process after SP is determined by many factors and cannot be significantly influenced solely by reinforcing tissue like the temporalis muscle flap or supporting materials.
authors.affiliation: Department of Otorhinolaryngology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany. lyutenski.stefan@mh-hannover.de.
authors.forename: Stefan
authors.initials: S
authors.lastname: Lyutenski
authors.affiliation: Department of Otorhinolaryngology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
authors.forename: Burkard
authors.initials: B
authors.lastname: Schwab
authors.affiliation: Department of Otorhinolaryngology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Lenarz
authors.affiliation: Department of Otorhinolaryngology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
authors.forename: Rolf
authors.initials: R
authors.lastname: Salcher
authors.affiliation: Department of Otorhinolaryngology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
authors.forename: Omid
authors.initials: O
authors.lastname: Majdani
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D002417:Cattle; D002648:Child; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010033:Otitis Media / Q000601:surgery*; D013506:Otologic Surgical Procedures; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D000072836:Surgical Wound; D016896:Treatment Outcome; D058106:Wound Closure Techniques; D014945:Wound Healing; D055815:Young Adult
keywords: Chronic otitis media; Subtotal petrosectomy; Temporalis muscle flap; Tympanomastoid obliteration