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Klinische Padiatrie Nov 2021
Topics: Adaptor Proteins, Signal Transducing; Congenital Bone Marrow Failure Syndromes; Humans; Mastoidectomy; Mutation; Neutropenia
PubMed: 34102700
DOI: 10.1055/a-1479-2692 -
The Journal of Laryngology and Otology Mar 2019In order to remove a cholesteatoma in the mastoid under transcanal endoscopic ear surgery, it is necessary to perform transcanal endoscopic mastoidectomy. Bone dust and...
BACKGROUND
In order to remove a cholesteatoma in the mastoid under transcanal endoscopic ear surgery, it is necessary to perform transcanal endoscopic mastoidectomy. Bone dust and blood, however, obscure the surgical field. A novel endoscopic hydro-mastoidectomy technique was developed, in which the operator performs the mastoidectomy 'underwater' using a lens cleaning system that provides saline perfusion in the surgical space.
METHODS
A curved round coarse diamond bur is attached to an otological drill. A lens cleaning sheath is fitted to the endoscope. The surgeon controls the infusion of saline solution by stepping on a footswitch of the power console.
RESULTS
Endoscopic hydro-mastoidectomy washes out bone dust and blood from the surgical field, improving the surgical view during mastoidectomy. Additionally, the operator can easily control the flow of saline perfusion.
CONCLUSION
This technique provides a clear surgical view by washing out bone dust and blood from the surgical area. The setup for endoscopic hydro-mastoidectomy technique is easy and the operator needs only to buy sheaths if they already own the power console, as many otological and rhinological surgeons do.
Topics: Cholesteatoma, Middle Ear; Humans; Male; Mastoidectomy; Middle Aged; Natural Orifice Endoscopic Surgery
PubMed: 30983562
DOI: 10.1017/S002221511900046X -
Otolaryngologic Clinics of North America Jun 1999Patients who have never had otologic surgery or whose previous surgery has preserved the bridge or canal wall can undergo an intact-bridge mastoidectomy. The... (Review)
Review
Patients who have never had otologic surgery or whose previous surgery has preserved the bridge or canal wall can undergo an intact-bridge mastoidectomy. The intact-bridge mastoidectomy can achieve the advantages of improved hearing (as in intact-wall techniques) and eradicated cholesteatoma (as in open-cavity techniques). This article reviews the surgical techniques of intact-bridge mastoidectomy.
Topics: Chronic Disease; Ear Ossicles; Humans; Mastoid; Mastoiditis; Ossicular Replacement; Otitis Media; Surgical Procedures, Operative; Tympanoplasty
PubMed: 10393786
DOI: 10.1016/s0030-6665(05)70152-3 -
American Journal of Otolaryngology 2022To evaluate iatrogenic facial nerve injury in mastoidectomy and its paralysis improvement result after nerve injury management.
OBJECTIVE
To evaluate iatrogenic facial nerve injury in mastoidectomy and its paralysis improvement result after nerve injury management.
METHODS
A retrospective review of medical records of 21 patients with iatrogenic facial nerve injury following mastoidectomy who underwent nerve injury management in a tertiary referral center.
RESULTS
There were nine males and 12 females, with a mean age of 40.4 ± 15.1 years. Cholesteatoma was the most common primary pathology (76.2%). Mastoidectomy was canal wall up in 8 patients and canal wall down in 13. Nerve injury was due to drilling in 10 patients and sharp tools in 11. The tympanic segment of the facial nerve was the most common injured site (50.0%). Decompression was the most common nerve injury management method (52.4%). Other injury management methods were end-to-end anastomosis (14.3%), great auricular nerve graft (23.8%), and facial-hypoglossal nerve transfer (9.5%). No statistically significant correlation was found between facial nerve function 3-6 months after injury management and the following factors: age, gender, primary pathology, type of mastoidectomy, surgeon's experience, nerve injury site, mechanism of trauma, and nerve injury management method and timing.
CONCLUSION
Regardless of the surgeon's experience or technique applied, a meticulous approach may be more valuable in decreasing the chance of iatrogenic facial nerve injury.
Topics: Adult; Ear, Middle; Facial Nerve; Facial Nerve Injuries; Facial Paralysis; Female; Humans; Iatrogenic Disease; Male; Mastoidectomy; Middle Aged; Retrospective Studies; Treatment Outcome
PubMed: 35523101
DOI: 10.1016/j.amjoto.2022.103472 -
Otology & Neurotology : Official... Sep 2022This study aimed to compare surgical and audiometric outcomes of tympanoplasty alone (T) to tympanoplasty and mastoidectomy (T&M) in patients without cholesteatoma. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
This study aimed to compare surgical and audiometric outcomes of tympanoplasty alone (T) to tympanoplasty and mastoidectomy (T&M) in patients without cholesteatoma.
DATABASES REVIEWED
According to PRISMA guidelines, English articles in PubMed, Scopus, CINAHL, and Cochrane Library databases from inception to 7/29/2021 were searched.
METHODS
Studies describing a comparison of patients who underwent T to patients who underwent T&M were included. Studies describing patients with cholesteatoma were excluded. Patient demographics, graft failure rates, and preoperative and postoperative audiological findings were collected. Mean differences (MD) and risk difference (RD) were calculated using RevMan 5.4. Heterogeneity was assessed using Q test and I2 statistic. Risk of bias was assessed using both version 2 of the Cochrane risk-of-bias tool for randomized trials and Risk of Bias in Non-randomized Studies of Interventions.
RESULTS
A total of 27 studies fulfilled eligibility with T (n = 1,711) and T&M (n = 1,186). When pooling the data, mean differences between T versus T&M for air bone gap (-0.3 dB: 95% CI = -1.9 to 1.3, p = 0.730) and pure tone average (1.9 dB: 95% CI = -0.3 to 4.2, p = 0.090) were not statistically significant. Graft failure was higher with T only (16.4% versus 14.2%) than T&M (RD = -0.04, 95% CI = -0.07 to -0.00, p = 0.030, I2 = 35%].
CONCLUSION
This study endorses clinically similar audiological outcomes and a reduced risk difference of graft failure with mastoidectomy. Although these data suggest that adding a mastoidectomy could decrease the risk of graft failure, the risk reduction is minimal. More research on the cost-effectiveness and the specific patient clinical characteristics and comorbidities that would benefit from adding a mastoidectomy is warranted.
Topics: Cholesteatoma; Cholesteatoma, Middle Ear; Chronic Disease; Humans; Mastoid; Mastoidectomy; Otitis Media; Retrospective Studies; Treatment Outcome; Tympanoplasty
PubMed: 35970151
DOI: 10.1097/MAO.0000000000003631 -
Acta Neurochirurgica May 2023The anterolateral (juxtacondylar) approach with limited mastoidectomy is a suitable option to expose the postero-inferior part of the jugular foramen (JF). It is...
BACKGROUND
The anterolateral (juxtacondylar) approach with limited mastoidectomy is a suitable option to expose the postero-inferior part of the jugular foramen (JF). It is particularly indicated for tumors extending in the neck beyond the jugular foramen, especially in those cases necessitating both neck control as well as control of the mastoid segment of facial nerve.
METHOD
We describe here the steps to safely perform an anterolateral approach with mastoidectomy along with a brief description of its indications and limits.
CONCLUSION
This approach represents a valid option to reach the JF. Its knowledge can improve the process of optimal approach selection when dealing with complex pathology involving the JF.
Topics: Humans; Meningioma; Jugular Foramina; Mastoidectomy; Neurosurgical Procedures; Head and Neck Neoplasms; Meningeal Neoplasms
PubMed: 36609565
DOI: 10.1007/s00701-022-05482-6 -
The Journal of Laryngology and Otology Aug 2019Retraction pocket theory is the most acceptable theory for cholesteatoma formation. Canal wall down mastoidectomy is widely performed for cholesteatoma removal....
BACKGROUND
Retraction pocket theory is the most acceptable theory for cholesteatoma formation. Canal wall down mastoidectomy is widely performed for cholesteatoma removal. Post-operatively, each patient with canal wall down mastoidectomy has an exteriorised mastoid cavity, exteriorised attic, neo-tympanic membrane and shallow neo-middle ear.
OBJECTIVE
This study aimed to clinically assess the status of the neo-tympanic membrane and the exteriorised attic following canal wall down mastoidectomy.
METHODS
All post canal wall down mastoidectomy patients were recruited and otoendoscopy was performed to assess the neo-tympanic membrane. A clinical classification of the overall status of middle-ear aeration following canal wall down mastoidectomy was formulated.
RESULTS
Twenty-five ears were included in the study. Ninety-two per cent of cases showed some degree of neo-tympanic membrane retraction, ranging from mild to very severe.
CONCLUSION
After more than six months following canal wall down mastoidectomy, the degree of retracted neo-tympanic membranes and exteriorised attics was significant. Eustachian tube dysfunction leading to negative middle-ear aeration was present even after the canal wall down procedure. However, there was no development of cholesteatoma, despite persistent retraction.
Topics: Abscess; Adolescent; Adult; Aged; Child; Cholesteatoma, Middle Ear; Cross-Sectional Studies; Female; Humans; Male; Mastoidectomy; Mastoiditis; Middle Aged; Otitis Media; Treatment Outcome; Young Adult
PubMed: 31267884
DOI: 10.1017/S0022215119001385 -
Ear, Nose, & Throat Journal Apr 2005We conducted a retrospective study of 53 mastoidectomies in 51 patients with acute otomastoiditis. In 26 cases (49.1%), surgery had been performed within 48 hours of the...
We conducted a retrospective study of 53 mastoidectomies in 51 patients with acute otomastoiditis. In 26 cases (49.1%), surgery had been performed within 48 hours of the development of symptoms. The most common complication of acute otomastoiditis was subperiosteal abscess, which occurred in 37 cases (69.8%). Intracranial complications were seen in 6 cases (11.3%). The most common pathogens isolated from subperiosteal abscesses, the mastoid cavity, and intracranial collections were Streptococcus spp and Staphylococcus aureus. In 14 cases (26.4%), conservative treatment failed to cure acute otomastoiditis; such cases should raise a suspicion of a subperiosteal abscess, an underlying cholesteatoma, or an infection caused by gram-negative bacteria. Upon hospital admission, patients should receive antibiotics that are effective against both gram-positive and gram-negative organisms. Patients with intracranial complications or facial nerve paralysis may require a combination of two or more antibiotics. Long-term follow-up is highly recommended.
Topics: Acute Disease; Adolescent; Adult; Aged; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Male; Mastoiditis; Middle Aged; Otologic Surgical Procedures; Retrospective Studies; Staphylococcal Infections; Streptococcal Infections
PubMed: 15929321
DOI: No ID Found -
Indian Journal of Otolaryngology and... Aug 2022To compare surgical outcomes with different meatoplasty techniques without removal of a cartilage piece in canal wall down mastoidectomy. Total 61 patients of canal wall...
To compare surgical outcomes with different meatoplasty techniques without removal of a cartilage piece in canal wall down mastoidectomy. Total 61 patients of canal wall down mastoidectomy included in the study where either inferior based flap technique or division in middle technique meatoplasty performed and 2 groups formed. Group A consisted of 33 patients and the inferior based flap technique of meatoplasty used in these patients. Group B consisted of 28 patients and the division in middle technique of meatoplasty used in these patients. Granulations, discharge or stenosis of canal were observed in less than 8% of cases in both the groups. Meatoplasty done without incision or excision of a piece of cartilage from pinna can be achieved with good success rates with either inferiorly based flap technique or division in middle technique.
PubMed: 36032872
DOI: 10.1007/s12070-020-02312-y -
The Journal of Laryngology and Otology Dec 2022This study aimed to investigate the effect of surgical incision on the auricle position in patients undergoing canal wall down mastoidectomy to treat chronic otitis...
OBJECTIVE
This study aimed to investigate the effect of surgical incision on the auricle position in patients undergoing canal wall down mastoidectomy to treat chronic otitis media.
METHODS
Thirty-four patients who had undergone canal wall down mastoidectomy with a post-auricular incision approach were included in the study. Patients who had a previous auricle deformity, who underwent limited mastoidectomy surgery or mastoid obliteration, or who were younger than 18 years of age were excluded. The distances of the upper and middle parts of the auricle to the mastoid were measured.
RESULTS
Measurements in the first post-operative year were found to be 13.15 ± 3.59 mm in the upper region and 16.29 ± 5.00 mm in the middle region. It was observed that the auricle was approaching the mastoid area in both regions.
CONCLUSION
In patients undergoing radical mastoidectomy, the distance between the auricle and the mastoid may decrease, leading to narrowing of the auriculo-cephalic angle.
Topics: Humans; Mastoidectomy; Treatment Outcome; Retrospective Studies; Mastoid; Tympanoplasty; Ear Canal; Cholesteatoma, Middle Ear
PubMed: 35177155
DOI: 10.1017/S0022215122000020