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Surgical results of retrograde mastoidectomy with primary reconstruction of the ear canal and mastoid cavity.

Kuo CY, Huang BR, Chen HC, Shih CP, Chang WK, Tsai YL, Lin YY, Tsai WC, Wang CH - Biomed Res Int (2015)

Bottom Line: The results suggested there was a significant gain in hearing following surgery, with respect to the postoperative change in both air-conduction thresholds and air-bone gaps (P < 0.001).The overall rate of postoperative adverse events was 8.8%.It gives excellent surgical results and has fewer postoperative adverse events.

View Article: PubMed Central - PubMed

Affiliation: Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, Taipei 114, Taiwan.

ABSTRACT
The aim of this study was to retrospectively review the long-term hearing results and the impact of mastoid exclusion/obliteration in patients with cholesteatoma (102 ears) who underwent retrograde tympanomastoidectomy and in whom bone chips/paté were applied as the sole materials during the procedure. In 79 ears, this was combined with ossiculoplasty in a single-stage procedure. In >71% of ears, the results of audiometric testing were monitored for more than 2 years. The results suggested there was a significant gain in hearing following surgery, with respect to the postoperative change in both air-conduction thresholds and air-bone gaps (P < 0.001). Linear regression analyses of pure-tone averages at different frequencies, before and after surgery, demonstrated that patients benefitted from a postoperative hearing gain at low and middle frequencies, but their hearing often deteriorated at frequencies of 8000 Hz. As for the impact of the type of tympanoplasty on hearing outcomes, type III-interposition markedly increased hearing gain. The overall rate of postoperative adverse events was 8.8%. We conclude that reconstruction of the ear canal and mastoid via mastoid exclusion/obliteration using bone chips/paté can be considered as an alternative procedure following retrograde mastoidectomy. It gives excellent surgical results and has fewer postoperative adverse events.

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Related in: MedlinePlus

Individual audiometric outcomes in PTA. Linear regression analyses of PTA before (x-axis, left scatter plots) and after (x-axis, right scatter plots) surgery at different frequency are shown. PTA, pure-tone average.
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fig3: Individual audiometric outcomes in PTA. Linear regression analyses of PTA before (x-axis, left scatter plots) and after (x-axis, right scatter plots) surgery at different frequency are shown. PTA, pure-tone average.

Mentions: To further investigate the postoperative changes in hearing thresholds at each octave frequency, an equation was derived through linear regression analysis of PTA before and after surgery. As demonstrated in Figure 3, a more negative slope (a decline from left to right) infers a greater postoperative improvement in hearing. Conversely, a positive slope implicates deterioration in postoperative hearing. Negative slopes were observed at 250, 500, 1000, 2000, and 4000 Hz. As the octave frequency increased from 250 to 1000 Hz, the gradient of the slope increased and was further removed from zero (−6.02 at 250 Hz, −6.08 at 500 Hz, and −6.52 at 1000 Hz, resp.). The slopes maintained negative values of −5.86 at 2000 Hz and −3.33 at 4000 Hz. However, a positive value of 2.84 was observed at 8000 Hz. These data indicate that patients who received surgery often experienced a hearing gain at low and middle frequencies, but their hearing deteriorated at a frequency of 8000 Hz.


Surgical results of retrograde mastoidectomy with primary reconstruction of the ear canal and mastoid cavity.

Kuo CY, Huang BR, Chen HC, Shih CP, Chang WK, Tsai YL, Lin YY, Tsai WC, Wang CH - Biomed Res Int (2015)

Individual audiometric outcomes in PTA. Linear regression analyses of PTA before (x-axis, left scatter plots) and after (x-axis, right scatter plots) surgery at different frequency are shown. PTA, pure-tone average.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4377362&req=5

fig3: Individual audiometric outcomes in PTA. Linear regression analyses of PTA before (x-axis, left scatter plots) and after (x-axis, right scatter plots) surgery at different frequency are shown. PTA, pure-tone average.
Mentions: To further investigate the postoperative changes in hearing thresholds at each octave frequency, an equation was derived through linear regression analysis of PTA before and after surgery. As demonstrated in Figure 3, a more negative slope (a decline from left to right) infers a greater postoperative improvement in hearing. Conversely, a positive slope implicates deterioration in postoperative hearing. Negative slopes were observed at 250, 500, 1000, 2000, and 4000 Hz. As the octave frequency increased from 250 to 1000 Hz, the gradient of the slope increased and was further removed from zero (−6.02 at 250 Hz, −6.08 at 500 Hz, and −6.52 at 1000 Hz, resp.). The slopes maintained negative values of −5.86 at 2000 Hz and −3.33 at 4000 Hz. However, a positive value of 2.84 was observed at 8000 Hz. These data indicate that patients who received surgery often experienced a hearing gain at low and middle frequencies, but their hearing deteriorated at a frequency of 8000 Hz.

Bottom Line: The results suggested there was a significant gain in hearing following surgery, with respect to the postoperative change in both air-conduction thresholds and air-bone gaps (P < 0.001).The overall rate of postoperative adverse events was 8.8%.It gives excellent surgical results and has fewer postoperative adverse events.

View Article: PubMed Central - PubMed

Affiliation: Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, Taipei 114, Taiwan.

ABSTRACT
The aim of this study was to retrospectively review the long-term hearing results and the impact of mastoid exclusion/obliteration in patients with cholesteatoma (102 ears) who underwent retrograde tympanomastoidectomy and in whom bone chips/paté were applied as the sole materials during the procedure. In 79 ears, this was combined with ossiculoplasty in a single-stage procedure. In >71% of ears, the results of audiometric testing were monitored for more than 2 years. The results suggested there was a significant gain in hearing following surgery, with respect to the postoperative change in both air-conduction thresholds and air-bone gaps (P < 0.001). Linear regression analyses of pure-tone averages at different frequencies, before and after surgery, demonstrated that patients benefitted from a postoperative hearing gain at low and middle frequencies, but their hearing often deteriorated at frequencies of 8000 Hz. As for the impact of the type of tympanoplasty on hearing outcomes, type III-interposition markedly increased hearing gain. The overall rate of postoperative adverse events was 8.8%. We conclude that reconstruction of the ear canal and mastoid via mastoid exclusion/obliteration using bone chips/paté can be considered as an alternative procedure following retrograde mastoidectomy. It gives excellent surgical results and has fewer postoperative adverse events.

Show MeSH
Related in: MedlinePlus