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Endoscopic epitympanic exploration in mucosal chronic otitis media: is canal wall up mastoidectomy really needed?

Published online by Cambridge University Press:  25 January 2021

A Das ,
S Mitra ,
S Hazra  and
A Sengupta
A Das
Affiliation:
Institute of Post-Graduate Medical Education and Research (‘IPGMER’) and Seth Sukhlal Karnani Memorial (‘SSKM’) Hospital, Kolkata, India
S Mitra*
Affiliation:
Institute of Post-Graduate Medical Education and Research (‘IPGMER’) and Seth Sukhlal Karnani Memorial (‘SSKM’) Hospital, Kolkata, India
S Hazra
Affiliation:
Institute of Post-Graduate Medical Education and Research (‘IPGMER’) and Seth Sukhlal Karnani Memorial (‘SSKM’) Hospital, Kolkata, India
A Sengupta
Affiliation:
Institute of Post-Graduate Medical Education and Research (‘IPGMER’) and Seth Sukhlal Karnani Memorial (‘SSKM’) Hospital, Kolkata, India
*
Author for correspondence: Dr Sandipta Mitra, Institute of Post-Graduate Medical Education and Research (‘IPGMER’) and Seth Sukhlal Karnani Memorial (‘SSKM’) Hospital, 244 AJC Bose Road, Kolkata700020, India E-mail: onlysandipta@gmail.com
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Abstract

Objective

To compare endoscopic epitympanic exploration with conventional canal wall up (cortical) mastoidectomy for mucosal chronic otitis media in terms of post-operative outcomes.

Methods

Seventy-six patients diagnosed with chronic otitis media (mucosal variety) were randomly assigned to two treatment groups: endoscopic epitympanic exploration and conventional canal wall up (cortical) mastoidectomy. The groups were compared in terms of: post-operative anatomical outcomes (graft uptake), middle-ear physiological outcomes (post-operative tympanometry), audiological outcomes (air–bone gap), surgical time, post-operative pain, vertigo, and long-term complications such as retraction pocket and re-perforation.

Results

There was a statistically significant difference between the groups in terms of mean air–bone gap at 12 months, surgical time, and median post-operative pain measured at 6 hours (p < 0.05). No statistically significant differences were noted in terms of: graft uptake at 1, 3 and 6 months, mean air–bone gap at 3 and 6 months, tympanometry at 3, 6 and 12 months, vertigo at 1 week, or long-term complications.

Conclusion

Endoscopic epitympanic exploration resulted in significantly better long-term audiological outcomes, shorter operating time and less pain compared with conventional canal wall up (cortical) mastoidectomy.

Keywords

Endoscopic Surgical ProcedureMastoidectomy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 135 , Issue 1 , January 2021 , pp. 39 - 44
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Footnotes

Dr S Mitra takes responsibility for the integrity of the content of the paper

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