Surgical management of middle ear cholesteatoma and reconstruction at the same time
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Introduction. The surgical management of cholesteatoma. You can opt for a closed technique (mastoidectomy simple) or open surgery (radical mastoidectomy). The open mastoidectomy with reconstruction of the posterior wall of the middle ear reconstruction in one surgery combines the advantages of both techniques as adequate surgical exposure, eradication of cholesteatoma and anatomical reconstruction of the middle ear structures.
Objective. To evaluate the surgical results in the management of cholesteatoma with the technique of open mastoidectomy with reconstruction of the posterior wall and the middle ear in one surgery.
Methods. Prospective analytical observational study conducted between 2009-2012 with patients undergoing this surgical technique in the Hospital Universitario del Valle, performing preoperative clinical monitoring and quarterly postoperative tomography and previous assessments of hearing and pre -and postoperative audiometry.
Results. 45 patients were studied. Mean Postoperative follow-up was 28 months. Surgical success was achieved in 93.3% of patients as measured by clinical and radiological follow. Hearing preservation was found after reconstruction of the hearing mechanism, based on measured audiometry auditory tone average (PTA) by the statistical test for paired samples between preoperative and postoperative PTA. (95% CI -1.47 to 12.15). Residual cholesteatoma was presented in 6.6%, three to four times lower than that reported in the literature.
Conclusions. This type of surgery can be considered a successful technique in the treatment of cholesteatoma in selected cases.
Smith JA, Danner CJ. Complications of chronic otitis media and cholesteatoma. Otolaryngol Clin North Am. 2006; 39(6): 1237-55.
Giannuzzi AL, Merkus P, Taibah A, Falcioni M. Congenital mastoid cholesteatoma: case series, definition, surgical key points, and literature review. Ann Otol Rhinol Laryngol. 2011; 120(11): 700-6.
Welkoborsky HJ. [Current concepts of the pathogenesis of acquired middle ear cholesteatoma]. Laryngorhinootologie. 2011; 90(1): 38-48.
Wang EW, Jung JY, Pashia ME, Nason R, Scholnick S, Chole RA. Otopathogenic Pseudomonas aeruginosa strains as competent biofilm formers. Arch Otolaryngol Head Neck Surg. 2005; 131(11): 983-9.
Ho SY, Kveton JF. Efficacy of the 2-staged procedure in the management of cholesteatoma. Arch Otolaryngol Head Neck Surg. 2003; 129(5): 541-5.
Schraff SA, Strasnick B. Pediatric cholesteatoma: a retrospective review. Int J Pediatr Otorhinolaryngol. 2006; 70(3): 385-93.
Nadol JB Jr. Revision mastoidectomy. Otolaryngol Clin North Am. 2006; 39(4): 723-40.
Kronenberg J, Shapira Y, Migirov L. Mastoidectomy reconstruction of the posterior wall and obliteration (MAPRO): preliminary results. Acta Otolaryngol. 2012; 132(4): 400-3.
Dornhoffer JL. Retrograde mastoidectomy with canal wall reconstruction: a follow-up report. Otol Neurotol. 2004; 25(5): 653-60.
Cimsit NC, Cimsit C, Baysal B, Ruhi IC, Ozbilgen S, Aksoy EA. Diffusion-weighted MR imaging in postoperative follow-up: reliability for detection of recurrent cholesteatoma. Eur J Radiol. 2010; 74(1): 121-3.
Lin JW, Oghalai JS. Can radiologic imaging replace second-look procedures for cholesteatoma? Laryngoscope. 2011; 121(1): 4-5.
Wilson KF. Tympanoplasty with intact canal wall mastoidectomy for Cholesteatoma: long term surgical outcomes. Otologaryngol Head Neck Surg. 2013; 149(2): 292-5
Harkness P. Brown P, Fowler S, Grant H, Ryan R, Topham J. Mastoidectomy audit: results of the Royal College of surgeons of England comparative audit of ENT surgery. Clin otolaryngol Alled Sci. 1995; 20(1): 89-94.
Lee K, Schiknecht HF. Results of tympanoplsty and mastoidectomy at the Massachusetts eyean ear infirmary. Laryngoscope. 1971; 81: 529-43.
Colletti v, Fiorino FG, Sittoni V. Minisculptured ossicle grafts versus implants: long term results. Am J Otol. 1987; 8: 553-9.
Goldenberg RA. Hydroxylapatite ossicular replacement prostheses: A four year experience. Otolaryngol Head Neck Surg. 1992; 106: 261-9.
Galdstone HB, Jackler RK, Varav K. Tympanic membrane wound healing. An overview. Otolaryngol Clin North Am. 1995; 28: 913–32.
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- Pedro Blanco, Diagnóstico y tratamiento de los síndromes estilohioideo y estiloide , Colombia Médica: Vol. 7 No. 3 (1976)
- Pedro Blanco, Ney Guzmán, Cáncer de laringe. Revisión clínica de 60 casos atendidos en el Hospital Universitario del Valle, Cali, 1964-1972 , Colombia Médica: Vol. 5 No. 4 (1974)
Accepted 2014-10-02
Published 2014-09-30
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