Hostname: page-component-76fb5796d-2lccl Total loading time: 0 Render date: 2024-04-27T01:23:37.129Z Has data issue: false hasContentIssue false
  • English
  • Français

Radical revision mastoidectomy for chronic otitis media without cholesteatoma: the relevance of excenteration of all rest cells

Published online by Cambridge University Press:  29 June 2007

Jan Rombout  and
Bernard K. H. Pauw
Jan Rombout*
Affiliation:
ENT Department Dijkzigt Hospital, Erasmus University Medical Centre, Rotterdam, The Netherlands.
Bernard K. H. Pauw
Affiliation:
ENT Department Dijkzigt Hospital, Erasmus University Medical Centre, Rotterdam, The Netherlands.
*
Address for correspondence: Jan Rombout, M. D., ENT-Department Dijkzigt Hospital, Erasmus University Medical Centre Rotterdam, PO Box 2040, 3000 CB Rotterdam, The Netherlands. Fax: +31 10 463 3102
Get access Rights & Permissions [Opens in a new window]

Abstract

Patients who, despite treatment, suffer persistent chronic otitis media (COM), a radical cavity and a hearing loss of more than 55 decibels for more than five years, can be classified as having an ‘endstage’ COM. It is generally agreed that retained infected residual cell tracts or a too small meatus are common causes for failure of surgery for COM. Radical revision mastoidectomy (RRM) aims to remove all residual cell tracts in the mastoid, in the middle-ear cleft, around the labyrinth and around the Eustachian tube. The mastoid cavity is obliterated with a pedicled muscle flap. Thus the mastoid cavity is reduced and selfcleansing is improved. The first 16 consecutive patients who underwent a RRM for ‘endstage’ COM were included in this study. In about 80 per cent the treatment resulted in a dry ear. We, therefore, conclude that RRM is an effective and safe method for treating ‘endstage’ COM.

Keywords

Otitis media, suppurativeSurgery, operative
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 113 , Issue 8 , August 1999 , pp. 710 - 713
Copyright
Copyright © JLO (1984) Limited 1999

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bartels, L. J., Sheehy, J. L. (1981) Total obliteration of the mastoid, middle ear, and external auditorycanal. A review of 27 cases. Laryngoscope 91: 1100–1108.CrossRefGoogle Scholar
Charachon, R., LeJeune, J. M., Bouchal, H. (1991) Reconstruction of radical mastoidectomy by obliteration technique. Ear, Nose and Throat Journal 70: 830–838.Google ScholarPubMed
Coker, N. J., Jenkins, H. A., Fisch, U. (1986) Obliteration of the middle ear and mastoid cleft in subtotal petrosectomy: indications, technique, and results. Annals of Otology, Rhinology and Laryngology 95: 5–11.CrossRefGoogle ScholarPubMed
East, C. A., Brough, M. D., Grant, H. R. (1991) Mastoid obliteration with the temporoparietal fascia flap. Journal of Laryngology and Otology 105: 417–420.CrossRefGoogle ScholarPubMed
Fagan, P. A. (1991) Modified radical mastoid surgery for chronic ear disease. [Review]. Annals of the Academy of Medicine, Singapore 20: 665–673.Google ScholarPubMed
Fisch, U. (1988) Microsurgery of the Skull Base. Thieme, New York.Google Scholar
Fisch, U., Schmid, S. (1991) Radical mastoido-epitympanectomy with tympanoplasty and partial obliteration: a new surgical procedure? Annals of the Academy of Medicine, Singapore 20: 614–617.Google ScholarPubMed
Gacek, R. R. (1979) Total obliteration of the chronic draining ear – how I do it. Journal of Otolaryngology 8: 515–516.Google ScholarPubMed
Gómez Ullate, R., Cristóbal, F., Ruiz, C., Arcocha, A. (1997) [Mastoid obliteration in open cavities]. Acta Otorrinolaringológica Española 48: 605–608.Google ScholarPubMed
Irving, R. M., Gray, R. F., Moffat, D. A. (1994) Bone pâté obliteration or revision mastoidectomy: a five-symptom comparative study. Clinical Otolaryngology 19: 158–160.CrossRefGoogle ScholarPubMed
Minatogawa, T., Machizuka, H., Kumoi, T. (1995a) Evaluation of mastoid obliteration surgery. American Journal of Otology 16: 99–103.Google ScholarPubMed
Minatogawa, T., Machizuka, H., Kumoi, T., Montandon, P., Benchaou, M., Guyot, J. P. (1995b) Evaluation of mastoid obliteration surgery. Modified canal wall-up mastoidectomy with mastoid obliteration for severe chronic otitis media. American Journal of Otology 16: 198–201.Google Scholar
Mosher, H. P. (1911) A method of filling the excavated mastoid with a flap from the back of the auricle. Laryngoscope 21: 1158–1163.CrossRefGoogle Scholar
Nadol, J. B. (1991) The hypotympanum and infralabyrinthine cells in chronic otitis media. Laryngoscope 101: 137–141.CrossRefGoogle ScholarPubMed
Ojala, K., Lahti, R., Palva, A., Sorri, M. (1983) Post-operative roentgenological findings and changes after mastoid obliteration. Journal of Laryngology and Otology 97: 393–398.CrossRefGoogle ScholarPubMed
Ojala, K., Sorri, M., Sipila, P., Palva, A. (1982) Late changes in ear canal volumes after mastoid obliteration. Archives of Otolaryngology 108: 208–209.CrossRefGoogle ScholarPubMed
Palva, T. (1989) Surgical control of the mastoid segment in chronic ear disease in 1988. Archives of Otorhinolaryngology 246: 274–276.CrossRefGoogle ScholarPubMed
Palva, T., Palva, A., Karja, J. (1972) Musculoperiosteal flap in cavity obliteration. Histopathological study seven years postoperatively. Archives of Otolaryngology 95: 172–177.CrossRefGoogle ScholarPubMed
Palva, T., Palva, A., Salmivalli, A. (1968) Radical mastoidectomy with cavity obliteration. Archives of Otolaryngology 88: 119–123.CrossRefGoogle ScholarPubMed
Parikh, A. A., Brookes, G. B. (1994) Subtotal petrosectomy with external canal overclosure in the management of chronic suppurative otitis media. Journal of Laryngology and Otology 108: 197–201.CrossRefGoogle ScholarPubMed
Pillsbury, H. D., Carrasco, V. N. (1990) Revision mastoidectomy. [Review]. Archives of Otolaryngology – Head and Neck Surgery 116: 1019–1022.CrossRefGoogle ScholarPubMed
Rambo, J. H. T. (1958) Primary closure of the radical mastoidectomy wound; a technique to eliminate post-operative care. Laryngoscope 68: 1216–1227.CrossRefGoogle Scholar
Schuknecht, H. F., Chandler, J. R. (1984) Surgical obliteration of the tympanomastoid compartment and external auditory canal. Annals of Otology, Rhinology and Laryngology 93: 641–645.CrossRefGoogle ScholarPubMed
Takahashi, S., Nakano, Y. (1996) A morphological study on obliteration of the temporal dorsal bullae using hydroxyapatite granules. American Journal of Otology 17: 197–199.Google Scholar
Vartiainen, E., Kansanen, M. (1992) Tympanomastoidectomy for chronic otitis media without cholesteatoma. Otolaryngology – Head and Neck Surgery 106: 230–234.CrossRefGoogle ScholarPubMed
Violaris, N. S., Donovan, R. (1989) Obliteration of the middle ear cleft. Journal of Laryngology and Otology 103: 43–45.CrossRefGoogle ScholarPubMed
Yung, M. M., Karia, K. R. (1997) Mastoid obliteration with hydroxyapatite – the value of high resolution CT scanning in detecting recurrent cholesteatoma. Clinical Otolaryngology 22: 553–557.CrossRefGoogle ScholarPubMed