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Application of tympanoplasty to solve the persistent otorrhea problem in the radical mastoidectomy cavity

Year 2019, , 280 - 283, 30.09.2019
https://doi.org/10.16899/jcm.582742

Abstract

Abstract

Background/Aims:To
evaluate the results of tympanoplasty to resolve the stubborn otorrhea problem
after a radical mastoidectomy.

Methods: Between October 2010 and February 2015, 18
patients who underwent tympanoplasty that underwent persistent otorrhea after radical
mastoidectomy in our ENT clinic were retrospectively evaluated.
Postoperatively, patients were called for a 3-month follow-up visit for 9
months. In the tympanoplasty procedure, the flat epithelium and mucosa,
covering the sinus tympani and promontorium invaded by cholesteatoma and
permanent granulation tissue, were elevated using the retroauricular approach. The
temporalis fascia graft was placed on the facial ridge, on the facial canal, on
the inferior meatal wall, and the lateral wall of the tuba auditiva. After the
tympanomeatal flap was placed on the lateral side of the fascia graft,
tympanoplasty was performed to create a mesotympanum.

Results:Cholesteatoma
or permanent granulation tissue was found in sinus tympani in all patients with
stubborn otorrhea. A statistically significant difference was found between the
variables of recurrent cholesteatoma of middle ear cholesteatoma and
postmastoidectomy cavity and facial ridge values (p <0.05). During
follow-up, it did not recur in cholesteatoma and permanent granulation tissues.

Conclusions: Otorrhea was successfully treated in all patients who
underwent tympanoplasty. Postoperative radical cavities of our patients were
healed, and the closed cavity was obtained.





References

  • Westerberg BD, Lee PK, Lukwago L, Zaramba S, Bubikere S, Stewart I. Cross-sectional survey of hearing impairment and ear disease in Uganda. Journal of Otolaryngology--Head & Neck Surgery. 2008;37(6).
  • Akinpelu O, Amusa Y, Komolafe E, Adeolu A, Oladele A, Ameye S. Challenges in management of chronic suppurative otitis media in a developing country. The Journal of Laryngology & Otology. 2008;122(1):16-20.
  • Maharjan M, Bhandari S, Singh I, Mishra S. Prevalence of otitis media in school going children in Eastern Nepal. Kathmandu University medical journal (KUMJ). 2006;4(4):479-82.
  • Shaan M, Landolfi M, Taibah A, Russo A, Szymanski M, Sanna M. Modified Bondy technique. The American journal of otology. 1995;16(5):695-7.
  • Görür K, Ozcan C, Unal M, Vayisoğlu Y. Causes of failure in open cavity mastoidectomy. Kulak burun bogaz ihtisas dergisi: KBB= Journal of ear, nose, and throat. 2002;9(3):179-83.
  • Wang H-M, Lin J-C, Lee K-W, Tai C-F, Wang L-F, Chang H-M, et al. Analysis of mastoid findings at surgery to treat middle ear cholesteatoma. Archives of Otolaryngology–Head & Neck Surgery. 2006;132(12):1307-10.
  • Kasenõmm P. Intraoperative findings of revision canal wall-down tympanomastoid surgery. Acta oto-laryngologica. 2013;133(8):826-32.
  • Cho Y-S, Hong SD, Chung KW, Hong SH, Chung W-H, Park SH. Revision surgery for chronic otitis media: characteristics and outcomes in comparison with primary surgery. Auris Nasus Larynx. 2010;37(1):18-22.
  • Brackmann D, Shelton C, Arriaga MA. Otologic Surgery E-Book: Elsevier Health Sciences; 2015.

Radikal mastoidektomi boşluğundaki inatçı otore problemini çözmek için yapılan timpanoplasti uygulaması

Year 2019, , 280 - 283, 30.09.2019
https://doi.org/10.16899/jcm.582742

Abstract

Öz

Amaç:Geçirilmiş radikal mastoidektomi operasyonu sonrası inatçı
otore problemini çözmek için timpanoplasti uygulamasının sonuçlarını
değerlendirmek.

Gereç ve Yöntem:Radikal
Mastoidektomi (RM) sonrası devam eden inatçı otore nedeniyle, hastanemiz KBB
kliniğinde Ekim 2010 - Şubat 2015 tarihleri arasında timpanoplasti uygulanan 18
hasta retrospektif olarak değerlendirildi. Postoperatif olarak hastalar 9 ay
boyunca 3 aylık kontrollere çağrıldı.

Timpanoplasti uygulamasında retroauriküler yaklaşım
kullanılarak kolesteatom ve kalıcı granülasyon dokusu tarafından istila edilen
sinüs timpani ve promontoryumu döşeyen yassı epitel ve mukoza eleve edildi. Temporal
fasya grefti,  facial ridge üzerine,
facial kanal üzerine, meatus'un alt duvarı üzerine ve tuba auditiva'nın lateral
duvarı üzerine yerleştirildi. Timpanomeatal flep fasya greftinin lateraline
yerleştirildikten sonra kapalı bir kulak boşluğu “mesotimpanum” oluşturmak için
timpanoplasti uygulandı.

Bulgular:İnatçı otoresi olan bütün hastaların hepsinde sinüs
timpanide kolesteatom veya kalıcı granülasyon dokusu bulundu. Orta kulak
kolestatomu ve postmastoidektomi kavitesinin rekurren kolestatomu değişkenleri
ile fasiyal ridge değerleri arasında istatistiksel bir anlamlılık bulunmuştur
(p<0,05). Takip süresince kolesteatom ve kalıcı granülasyon dokularında nüks
etmedi. 

Tartışma:Timpanoplasti yapılan tüm hastalarda otore başarılı bir
şekilde tedavi edildi. Ameliyat sonrası hastalarımızın radikal boşlukları
iyileşti ve kapalı kavite elde edildi.

References

  • Westerberg BD, Lee PK, Lukwago L, Zaramba S, Bubikere S, Stewart I. Cross-sectional survey of hearing impairment and ear disease in Uganda. Journal of Otolaryngology--Head & Neck Surgery. 2008;37(6).
  • Akinpelu O, Amusa Y, Komolafe E, Adeolu A, Oladele A, Ameye S. Challenges in management of chronic suppurative otitis media in a developing country. The Journal of Laryngology & Otology. 2008;122(1):16-20.
  • Maharjan M, Bhandari S, Singh I, Mishra S. Prevalence of otitis media in school going children in Eastern Nepal. Kathmandu University medical journal (KUMJ). 2006;4(4):479-82.
  • Shaan M, Landolfi M, Taibah A, Russo A, Szymanski M, Sanna M. Modified Bondy technique. The American journal of otology. 1995;16(5):695-7.
  • Görür K, Ozcan C, Unal M, Vayisoğlu Y. Causes of failure in open cavity mastoidectomy. Kulak burun bogaz ihtisas dergisi: KBB= Journal of ear, nose, and throat. 2002;9(3):179-83.
  • Wang H-M, Lin J-C, Lee K-W, Tai C-F, Wang L-F, Chang H-M, et al. Analysis of mastoid findings at surgery to treat middle ear cholesteatoma. Archives of Otolaryngology–Head & Neck Surgery. 2006;132(12):1307-10.
  • Kasenõmm P. Intraoperative findings of revision canal wall-down tympanomastoid surgery. Acta oto-laryngologica. 2013;133(8):826-32.
  • Cho Y-S, Hong SD, Chung KW, Hong SH, Chung W-H, Park SH. Revision surgery for chronic otitis media: characteristics and outcomes in comparison with primary surgery. Auris Nasus Larynx. 2010;37(1):18-22.
  • Brackmann D, Shelton C, Arriaga MA. Otologic Surgery E-Book: Elsevier Health Sciences; 2015.
There are 9 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Original Research
Authors

Ahmet Hamdi Kepekçi 0000-0002-5332-5234

Cengiz Çelıkyurt This is me 0000-0002-9292-5558

Publication Date September 30, 2019
Acceptance Date September 4, 2019
Published in Issue Year 2019

Cite

AMA Kepekçi AH, Çelıkyurt C. Radikal mastoidektomi boşluğundaki inatçı otore problemini çözmek için yapılan timpanoplasti uygulaması. J Contemp Med. September 2019;9(3):280-283. doi:10.16899/jcm.582742