Necessity of mastoidectomy in patients with chronic otitis media having sclerotic mastoid bone: a retrospective clinical study

Abstract

Objectives: This study aims to investigate the efficiency of mastoidectomy during tympanoplasty procedures in patients having sclerotic mastoid bone with dry or dried up tympanic cavity. Patients and Methods: The study included 146 patients 66 males, 80 females; mean age 28.6 years; range 16 to 52 years having sclerotic mastoid bone who underwent tympanoplasty between March 2010 and March 2013. Patients were divided into two groups: group A 34 males, 58 females; mean age 25.8 years; range 17 to 47 years underwent only tympanoplasty, while tympanoplasty + mastoidectomy were performed on group B 32 males, 22 females; mean age 29.8 years; range 16 to 52 years . All outcomes were evaluated including the actual state of the tympanic membrane graft and level of hearing. Results: While postoperative perforation and retraction rates were not significantly different between the two groups, results of group A were superior to group B in terms of operation duration and hearing results. Conclusion: Mastoidectomy is not an efficient procedure in chronic otitis media patients having sclerotic mastoid bone with dry or dried up tympanic cavity.

Keywords

• Chronic otitis media, mastoidectomy, tympanoplasty

Sklerotik mastoid kemiği olan kronik otitis medialı hastalarda mastoidektominin gerekliliği: retrospektif bir klinik çalışma

Abstract

Amaç: Bu çalışmada kuru veya kurutulmuş timpanik kavite olan, sklerotik mastoid kemiği olan hastalarda timpanoplasti işlemleri sırasında mastoidektominin etkinliği araştırıldı.Hastalar ve Yöntemler: Çalışmaya sklerotik mastoid kemiği olup Mart 2010 ve Mart 2013 tarihleri arasında timpanoplasti geçiren 146 hasta 66 erkek, 80 kadın; ort. yaş 28.6 yıl; dağılım 16-52 yıl dahil edildi. Hastalar iki gruba ayrıldı: grup A 34 erkek, 58 kadın, ort. yaş 25.8 yıl; dağılım 17-47 yıl sadece timpanoplasti geçirirken grup B’ye 32 erkek, 22 kadın; ort. yaş 29.8 yıl; dağılım 16-52 yıl timpanoplasti + mastoidektomi uygulandı. Timpanik membran greftinin mevcut durumu ve işitme düzeyi dahil tüm sonuçlar değerlendirildi.Bulgular: İki grup arasında ameliyat sonrası perforasyon ve retraksiyon oranları anlamlı olarak farklı olmasa da ameliyat süresi ve işitme sonuçları açısından grup A’nın sonuçları grup B’den üstündü.Sonuç: Kuru veya kurutulmuş timpanik kavite olan, sklerotik mastoid kemiği olan hastalarda mastoidektomi etkin bir işlem değildir

Keywords

• Kronik otitis media, mastoidektomi, timpanoplasti

References

1. Nadol JB Jr, Staecker H, Gliklich RE. Outcomes assessment for chronic otitis media: the Chronic Ear Survey. Laryngoscope 2000;110:32-5.
2. Verhoeff M, van der Veen EL, Rovers MM, Sanders EA, Schilder AG. Chronic suppurative otitis media: a review. Int J Pediatr Otorhinolaryngol 2006;70:1-12.
3. Cho YS, Choi SH, Park KH, Park HJ, Kim JW, Moon IJ, et al. Prevalence of otolaryngologic diseases in South Korea: data from the Korea national health and nutrition examination survey 2008. Clin Exp Otorhinolaryngol 2010;3:183-93.
4. Jung KH, Cho YS, Hong SH, Chung WH, Lee GJ, Hong SD. Quality-of-life assessment after primary and revision ear surgery using the chronic ear survey. Arch Otolaryngol Head Neck Surg 2010;136:358-65.
5. Sheehy JL. Mastoidectomy: the intact canal wall procedure. In: Brackmann DE, editor. Otologic surgery. Philadelphia: W.B. Saunders; 1994. p. 211-24.
6. McGrew BM, Jackson CG, Glasscock ME. Impact of mastoidectomy on simple tympanic membrane perforation repair. Laryngoscope 2004;114:506-11.
7. Lau T, Tos M. Long-term results of surgery for chronic granulating otitis. Am J Otolaryngol 1986;7:341-5.
8. Tos M. Indications for surgery and preoperative management. In: Tos M, editor. Manual of middle ear surgery. New York: Thieme; 1993. p. 4-6.

9. Vartiainen E, Kansanen M. Tympanomastoidectomy for chronic otitis media without cholesteatoma. Otolaryngol Head Neck Surg 1992;106:230-4.
10. Mutoh T, Adachi O, Tsuji K, Okunaka M, Sakagami M. Efficacy of mastoidectomy on MRSA-infected chronic otitis media with tympanic membrane perforation. Auris Nasus Larynx 2007;34:9-13.
11. Balyan FR, Celikkanat S, Aslan A, Taibah A, Russo A, Sanna M. Mastoidectomy in noncholesteatomatous chronic suppurative otitis media: is it necessary? Otolaryngol Head Neck Surg 1997;117:592-5.
12. Mishiro Y, Sakagami M, Takahashi Y, Kitahara T, Kajikawa H, Kubo T. Tympanoplasty with and without mastoidectomy for non-cholesteatomatous chronic otitis media. Eur Arch Otorhinolaryngol 2001;258:13-5.
13. Sade J. The atelectatic ear. In: Sade J, editor. Secretory otitis media and its sequelae. London: Churchill Livingstone; 1979. p. 64-8.
14. Webb BD, Chang CY. Efficacy of tympanoplasty without mastoidectomy for chronic suppurative otitis media. Arch Otolaryngol Head Neck Surg 2008;134:1155-8.
15. Ruhl CM, Pensak ML. Role of aerating mastoidectomy in noncholesteatomatous chronic otitis media. Laryngoscope 1999;109:1924-7.
16. Holmquist J, Bergström B. The mastoid air cell system in ear surgery. Arch Otolaryngol 1978;104:127-9.
17. Toros SZ, Habesoglu TE, Habesoglu M, Bolukbasi S, Naiboglu B, Karaca CT, et al. Do patients with sclerotic mastoids require aeration to improve success of tympanoplasty? Acta Otolaryngol 2010;130:909-12.
18. Mishiro Y, Sakagami M, Kondoh K, Kitahara T, Kakutani C. Long-term outcomes after tympanoplasty with and without mastoidectomy for perforated chronic otitis media. Eur Arch Otorhinolaryngol 2009;266:819-22.
19. Mane R, Patil B, Mohite A, Varute VV. Bilateral type 1 tympanoplasty in chronic otitis media. Indian J Otolaryngol Head Neck Surg 2013;65:293-7.