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Clinical assessment of patients with chronic otitis media with cholesteatoma

Year 2002, Volume: 9 Issue: 4, 263 - 266, 30.08.2002

Abstract

Objectives: We evaluated clinical features and treatment results of patients with chronic otitis media COM with cholesteatoma.Patients and Methods: The study included 83 patients 53 males, 30 females; mean age 27.5 years; range 7 to 60 years who were treated for COM with cholesteatoma. Ali patients undervvent otoscopic examination, audiometric investigation, temporal bone computed tomography, and when necessary, cranial tomography. Öpen or closed mas- toidectomy was performed depending on the extent of cholesteatoma and perioperative appearance of the ear.Results: Open- and closed-technique mastoidectomies were performed in 64 and 19 patients, respectively. Ossicular chain defects were observed in 90.3% of patients, and 9.7% had no detectable ossicular chain. Cranial complications were present in 28%. Of patients who had undergone öpen mastoidectomy, 75% had dry ears, 11% had recurrent ear discharge, and 14% required revision mastoidectomy because of recurrence. Of those who had been treated by closed-technique, 79% had dry ears, vvhereas 21% required revision mastoidectomy. Recurrent cholesteatoma was detected in 85% of patients during revision mastoidectomy.Conclusion: We prefer open-technique mastoidectomy in chronic otitis media patients with extensive cholesteatoma, bone destruction, and hearing impairment. This choice mainly relies on the socioeconomic status of patients and difficulty in having patient compliance with follow-up Controls.

References

  • Akyıldız N. Kulak hastalıkları ve mikro cerrahisi. Ankara: Bilimsel Tıp Yayınevi; 1998.
  • Jackson CG, Glasscock ME 3rd, Nissen AJ, Schwaber MK, Bojrab DI. Open mastoid procedures: contempo- rary indications and surgical technique. Laryngoscope 1985;95(9 Pt 1):1037-43.
  • Sheehy JL. Acquired cholesteatoma in adults. Otolaryngol Clin North Am 1989;22:967-79.
  • Holt JJ. Ear canal cholesteatoma. Laryngoscope 1992; 102:608-13.
  • Parisier SC. Management of cholesteatoma. Otolaryngol Clin North Am 1989;22:927-40.
  • Prescott CA, Malan JF. Mastoid surgery at the Red Cross War Memorial Children’s Hospital 1986-1988. J Laryngol Otol 1991;105:409-12.
  • Vartiainen E, Karja J, Karjalainen S. Surgery of chronic otitis media in young patients. J Laryngol Otol 1986; 100:515-9.
  • Pillsbury HC 3rd, Carrasco VN. Revision mastoidecto- m y. Arch Otolaryngol Head Neck Surg 1990;11 6 : 1 0 1 9 - 2 2 .
  • Sheehy JL. Cholesteatoma surgery: canal wall down procedures. Ann Otol Rhinol Laryngol 1988;97:30-5.
  • East CA, Brough MD, Grant HR. Mastoid obliteration with the temporoparietal fascia flap. J Laryngol Otol 1991;105:417-20.
  • Palva T. Surgical treatment of chronic middle ear dis- ease. III. Revisions after tympanomastoid surg e r y. Acta Otolaryngol 1988;105:82-9.
  • Austin DF. Single-stage surgery for cholesteatoma: an actuarial analysis. Am J Otol 1989;10:419-25.
  • Solomons NB, Robinson JM. Obliteration of mastoid cavities using bone pate. J Laryngol Otol 1988;102:783-4.
  • Tos M, Lau T. Late results of surgery in diff e re n t cholesteatoma types. ORL J Otorhinolaryngol Relat Spec 1 9 8 9 ; 5 1 : 3 3 - 4 9 .
  • Nadol JB Jr. Causes of failure of mastoidectomy for chronic otitis media. Laryngoscope 1985;95:410-3.
  • Sade J. Treatment of cholesteatoma. Am J Otol 1987;8: 524-33.
  • Goldenberg RA. Sink-trap effect as a cause of failure in mastoidectomy. Laryngoscope 1988;98:1143-4.
  • Lau T, Tos M. Cholesteatoma in children: recurrence related to observation period. Am J Otolaryngol 1987; 8:364-75.
  • Mills RP, Padgham ND. Management of childhood cholesteatoma. J Laryngol Otol 1991;105:343-5.
  • Rosenfeld RM, Moura RL, Bluestone CD. Predictors of re s i d u a l - re c u r rent cholesteatoma in children. Arc h Otolaryngol Head Neck Surg 1992;118:384-91.
  • Schloss MD, Terraza O. Cholesteatoma in children. J Otolaryngol 1991;20:43-5.
  • Egeli E, Kutluhan A, Kırıfl M, Çankaya H, Akkaya S, İnalkaç E. Kronik otitis media nedeniyle opere edilen 92 vakanın retrospektif analizi. Türk ORL Arflivi 1998; 36:122-5.

Kolesteatomlu kronik otitis media: Olguların klinik değerlendirilmesi

Year 2002, Volume: 9 Issue: 4, 263 - 266, 30.08.2002

Abstract

Amaç: Çalıflmada kolesteatomlu kronik otitis media tanısıyla tedavi gören KOM hastaların klinik özellikleri ve tedavi sonuçları değerlendirildi. Hastalar ve Yöntemler: Çalıflmaya kolesteatomlu KOMtanısı konan 83 hasta alındı. Olgular, otoskopik muayene, odyometrik inceleme, temporal kemik bilgisayarlı tomografisi;komplikasyon geliflen olgular da beyin bilgisayarlı tomografisi ile değerlendirildi. Kolesteatomun yaygınlığı ve kulağın ameliyat sırasındaki görünümü değerlendirilerek açıkveya kapalı teknik mastoidektomi uygulandı.Bulgul a r : Olguların 64’üne açık, 19’una kapalı teknik mastoidektomi uygulandı. Olguların %90.3’ünde kemikçik zincirdefekti saptandı; %9.7’sinde ise kemikçik zincir izlenmedi.Kranyal komplikasyon oranı %28 bulundu. Ameliyat sonrasıizlemde, açık kavite mastoidektomi yapılan hastaların%75’inde kuru kulak elde edilirken, %11’inde tekrarlayan kulak akıntısı gözlendi; %14’ünde nüks nedeniyle revizyonmastoidektomi yapıldı. Kapalı kavite mastoidektomi yapılanolguların %79’unda kuru kulak elde edildi; %21’inde revizyonmastoidektomi yapıldı. Revizyon mastoidektomi yapılan olguların %85’inde nüks kolesteatom saptandı.Sonuç: Yaygın kolesteatoma, kemik destrüksiyonu bulunan, iflitmenin kötü olduğu olgularda açık teknik yaklaflımıtercih ediyoruz. Bunun bafllıca nedenlerinden biri, hastaların, bölgemizin sosyoekonomik koflulları nedeniyle kontrollere gelmemesidir

References

  • Akyıldız N. Kulak hastalıkları ve mikro cerrahisi. Ankara: Bilimsel Tıp Yayınevi; 1998.
  • Jackson CG, Glasscock ME 3rd, Nissen AJ, Schwaber MK, Bojrab DI. Open mastoid procedures: contempo- rary indications and surgical technique. Laryngoscope 1985;95(9 Pt 1):1037-43.
  • Sheehy JL. Acquired cholesteatoma in adults. Otolaryngol Clin North Am 1989;22:967-79.
  • Holt JJ. Ear canal cholesteatoma. Laryngoscope 1992; 102:608-13.
  • Parisier SC. Management of cholesteatoma. Otolaryngol Clin North Am 1989;22:927-40.
  • Prescott CA, Malan JF. Mastoid surgery at the Red Cross War Memorial Children’s Hospital 1986-1988. J Laryngol Otol 1991;105:409-12.
  • Vartiainen E, Karja J, Karjalainen S. Surgery of chronic otitis media in young patients. J Laryngol Otol 1986; 100:515-9.
  • Pillsbury HC 3rd, Carrasco VN. Revision mastoidecto- m y. Arch Otolaryngol Head Neck Surg 1990;11 6 : 1 0 1 9 - 2 2 .
  • Sheehy JL. Cholesteatoma surgery: canal wall down procedures. Ann Otol Rhinol Laryngol 1988;97:30-5.
  • East CA, Brough MD, Grant HR. Mastoid obliteration with the temporoparietal fascia flap. J Laryngol Otol 1991;105:417-20.
  • Palva T. Surgical treatment of chronic middle ear dis- ease. III. Revisions after tympanomastoid surg e r y. Acta Otolaryngol 1988;105:82-9.
  • Austin DF. Single-stage surgery for cholesteatoma: an actuarial analysis. Am J Otol 1989;10:419-25.
  • Solomons NB, Robinson JM. Obliteration of mastoid cavities using bone pate. J Laryngol Otol 1988;102:783-4.
  • Tos M, Lau T. Late results of surgery in diff e re n t cholesteatoma types. ORL J Otorhinolaryngol Relat Spec 1 9 8 9 ; 5 1 : 3 3 - 4 9 .
  • Nadol JB Jr. Causes of failure of mastoidectomy for chronic otitis media. Laryngoscope 1985;95:410-3.
  • Sade J. Treatment of cholesteatoma. Am J Otol 1987;8: 524-33.
  • Goldenberg RA. Sink-trap effect as a cause of failure in mastoidectomy. Laryngoscope 1988;98:1143-4.
  • Lau T, Tos M. Cholesteatoma in children: recurrence related to observation period. Am J Otolaryngol 1987; 8:364-75.
  • Mills RP, Padgham ND. Management of childhood cholesteatoma. J Laryngol Otol 1991;105:343-5.
  • Rosenfeld RM, Moura RL, Bluestone CD. Predictors of re s i d u a l - re c u r rent cholesteatoma in children. Arc h Otolaryngol Head Neck Surg 1992;118:384-91.
  • Schloss MD, Terraza O. Cholesteatoma in children. J Otolaryngol 1991;20:43-5.
  • Egeli E, Kutluhan A, Kırıfl M, Çankaya H, Akkaya S, İnalkaç E. Kronik otitis media nedeniyle opere edilen 92 vakanın retrospektif analizi. Türk ORL Arflivi 1998; 36:122-5.
There are 22 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Muhammet Tekin This is me

Üstün Osma This is me

Faruk Meriç This is me

İsmail Topçu This is me

Publication Date August 30, 2002
Published in Issue Year 2002 Volume: 9 Issue: 4

Cite

APA Tekin, M., Osma, Ü., Meriç, F., Topçu, İ. (2002). Kolesteatomlu kronik otitis media: Olguların klinik değerlendirilmesi. The Turkish Journal of Ear Nose and Throat, 9(4), 263-266.
AMA Tekin M, Osma Ü, Meriç F, Topçu İ. Kolesteatomlu kronik otitis media: Olguların klinik değerlendirilmesi. Tr-ENT. August 2002;9(4):263-266.
Chicago Tekin, Muhammet, Üstün Osma, Faruk Meriç, and İsmail Topçu. “Kolesteatomlu Kronik Otitis Media: Olguların Klinik değerlendirilmesi”. The Turkish Journal of Ear Nose and Throat 9, no. 4 (August 2002): 263-66.
EndNote Tekin M, Osma Ü, Meriç F, Topçu İ (August 1, 2002) Kolesteatomlu kronik otitis media: Olguların klinik değerlendirilmesi. The Turkish Journal of Ear Nose and Throat 9 4 263–266.
IEEE M. Tekin, Ü. Osma, F. Meriç, and İ. Topçu, “Kolesteatomlu kronik otitis media: Olguların klinik değerlendirilmesi”, Tr-ENT, vol. 9, no. 4, pp. 263–266, 2002.
ISNAD Tekin, Muhammet et al. “Kolesteatomlu Kronik Otitis Media: Olguların Klinik değerlendirilmesi”. The Turkish Journal of Ear Nose and Throat 9/4 (August 2002), 263-266.
JAMA Tekin M, Osma Ü, Meriç F, Topçu İ. Kolesteatomlu kronik otitis media: Olguların klinik değerlendirilmesi. Tr-ENT. 2002;9:263–266.
MLA Tekin, Muhammet et al. “Kolesteatomlu Kronik Otitis Media: Olguların Klinik değerlendirilmesi”. The Turkish Journal of Ear Nose and Throat, vol. 9, no. 4, 2002, pp. 263-6.
Vancouver Tekin M, Osma Ü, Meriç F, Topçu İ. Kolesteatomlu kronik otitis media: Olguların klinik değerlendirilmesi. Tr-ENT. 2002;9(4):263-6.