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Intraoperative endoscopy of the anterior epitympanum recess through the posterior tympanotomy

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ABSTRACT

Introduction: The anterior epitympanum recess (AER) is a common place of the development of the cholesteatoma, which is why removal of the matrix from this area plays a key role in the surgical treatment of chronic otitis media.

Aim: To evaluate the intraoperative visibility of AER in endoscopic optics in comparison to microscopic optics and to determine the prevalence of cholesteatoma in various types of construction of the AER. Study design: retrospective analysis of intraoperative search.

Material and methods: The study included 55 patients treated in the Department of Otolaryngology, Medical University of Warsaw within the years 2009–2011, who underwent endoscopy-assisted canal wall up tympanoplasty with posterior tympanotomy. The type of construction of the AER – cellular or dome-shaped – was determined.

Results: Cellular type of recess was found intraoperatively in 32% of ears and dome-shaped in 68% of the study group. The population with chronic otitis media does not differ significantly compared to the general population in terms of the construction of the anterior epitympanum recess (p = 0.668108; χ2 = 0.1838235, df = 1). Among the ears with cholesteatoma a cellular AER was found in 48.3% of cases and a dome-shaped AER was found in 51.7%.

Conclusions: The cellular type of AER was significantly more frequent in ears with cholesteatoma (p < 0.01, χ2 = 29.86492, df = 1). Level of evidence: 1b.

No MeSH data available.


Related in: MedlinePlus

Cholesteatoma matrix remnant in epitympanic anterior space – left ear, 30° optics introduced by the posterior tympanotomy
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f0003: Cholesteatoma matrix remnant in epitympanic anterior space – left ear, 30° optics introduced by the posterior tympanotomy

Mentions: Cholesteatoma develops usually in the AER due to a retraction pocket; therefore the possibility of total insight is crucial during surgery. Access by posterior tympanotomy allows one to gain an excellent view into this area, albeit limited by the bone of the lateral wall of the attic and the medial part of the posterior wall of the external auditory canal. The endoscope 30° optics allowed for viewing medially and anteriorly from the head of the malleus and removing the remaining matrix or cholesteatoma which was not visible by the surgical microscope (Photos 3, 4).


Intraoperative endoscopy of the anterior epitympanum recess through the posterior tympanotomy
Cholesteatoma matrix remnant in epitympanic anterior space – left ear, 30° optics introduced by the posterior tympanotomy
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5095271&req=5

f0003: Cholesteatoma matrix remnant in epitympanic anterior space – left ear, 30° optics introduced by the posterior tympanotomy
Mentions: Cholesteatoma develops usually in the AER due to a retraction pocket; therefore the possibility of total insight is crucial during surgery. Access by posterior tympanotomy allows one to gain an excellent view into this area, albeit limited by the bone of the lateral wall of the attic and the medial part of the posterior wall of the external auditory canal. The endoscope 30° optics allowed for viewing medially and anteriorly from the head of the malleus and removing the remaining matrix or cholesteatoma which was not visible by the surgical microscope (Photos 3, 4).

View Article: PubMed Central - PubMed

ABSTRACT

Introduction: The anterior epitympanum recess (AER) is a common place of the development of the cholesteatoma, which is why removal of the matrix from this area plays a key role in the surgical treatment of chronic otitis media.

Aim: To evaluate the intraoperative visibility of AER in endoscopic optics in comparison to microscopic optics and to determine the prevalence of cholesteatoma in various types of construction of the AER. Study design: retrospective analysis of intraoperative search.

Material and methods: The study included 55 patients treated in the Department of Otolaryngology, Medical University of Warsaw within the years 2009–2011, who underwent endoscopy-assisted canal wall up tympanoplasty with posterior tympanotomy. The type of construction of the AER – cellular or dome-shaped – was determined.

Results: Cellular type of recess was found intraoperatively in 32% of ears and dome-shaped in 68% of the study group. The population with chronic otitis media does not differ significantly compared to the general population in terms of the construction of the anterior epitympanum recess (p = 0.668108; χ2 = 0.1838235, df = 1). Among the ears with cholesteatoma a cellular AER was found in 48.3% of cases and a dome-shaped AER was found in 51.7%.

Conclusions: The cellular type of AER was significantly more frequent in ears with cholesteatoma (p < 0.01, χ2 = 29.86492, df = 1). Level of evidence: 1b.

No MeSH data available.


Related in: MedlinePlus