Clinical trial to evaluate the outcome of canal wall up and canal wall down tympanomastoidectomy
Clinical trial to evaluate the outcome of canal wall up and canal wall down tympanomastoidectomy
Aim: The aim of this study was to evaluate the hearing outcomes of chronic suppurative otitis media surgery. Chronic suppurativeotitis media (CSOM) surgery composed of two procedure; canal wall up mastoidectomy (CWU) and canal wall down mastoidectomy(CWD).Material and Methods:The study included 29 patients with CSOM diagnosis and patients a mean age of 37.02 ± 2.4 years (y). Thedemographic features (age, gender), clinical features and intraoperative findings of the patients were recorded. Patients’ hearing wasevaluated with pure tone audiometry (PTA) at 0.5, 1, 2, 4 and 8 kHz and pre-postoperative air bone gap (ABG) difference. Pre- andpost-operative air-bone gap (ABG) at 12 months after ossiculoplasty. There were 8 patients who underwent CWD and 21 patientswho underwent CWU.Results: TWhen preoperative and postoperative ABG for the patients are compared, there were statistically significant differencesidentified at 0.5, 1, 2 and 8 kHz. However, there was no statistically significant difference identified at 4 kHz.Conclusion: Regardless to the surgical technique, statistically significant levels of hearing gain were provided at 0.5, 1, 2 and 8 kHz;however, there was no hearing gain at 4 kHz after the surgical procedure.
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- 1. Cheng-Chuan C, Mu-Kuan C. Canal-wall-down tympanoplasty with mastoidectomy for advanced cholesteatoma. Otolaryngol Head Neck Surg 2000; 29:270.
- 2. Chamoli P, Singh CV, Radia S et al. Functional and anatomical outcome of inside out technique for cholesteatoma surgery. American J Otolaryngol 2018; 39:423-30.
- 3. Gaillardin L, Lescanne E, Morinière S et al. Residual cholesteatoma: prevalence and location. Follow-up strategy in adults. Eur Ann Otorhinolaryngol Head Neck Dis 2012;129:136-40.
- 4. Tomlin J, Chang D, McCutcheon B et al. Surgical technique and recurrence in cholesteatoma: a metaanalysis. Audiol Neurootol 2013;18:135-42.
- 5. Kerckhoffs KG, Kommer MB, van Strien, TH et al. The disease recurrence rate after the canal wall up or canal wall down technique in adults. Laryngoscope 2016;126:980-7.
- 6. Segalla DK, Nakao LH, Anjos MF et al. Resultados cirúrgicos e audiológicos pós mastoidectomia em um serviço de Residência Médica. Acta Otorrinolaringol 2008;26:178-81.
- 7. Vartiainen E, Nuutinen J. Long-term hearing results of one-stage tympanoplasty for chronic otitis media. Eur Arch Otorhinolaryngol 1992;249: 329-31.
- 8. Veldman JE, Braunius WW. Revision surgery for chronic otitis media: a learning experience: report on 389 cases with a long-term follow-up. Ann Otol Rhinol Laryngol 1998;107: 486-491.
- 9. Cruz LMO, Kasse CA, Leonhart FD. Efficacy of surgical treatment of chronic otitis media. Otolaryngol Head Neck Surg 2003;128:263-6.
- 10. Cruz LMO, Kasse CA, Leonhart FD. Eficácia do tratamento cirurgico da otite média crônica colesteatomatosa. Braz J Otorhinolaryngol 2001; 67:142-6.
- 11. Cook JA, Krishnan S, Fagan PA. Hearing results following modified radical versus canal-up mastoidectomy. Ann Otol Rhinol Laryngo 1996;105: 379-83.
- 12. Cheng-Chuan C, & Mu-Kuan, C. Canal-wall-down tympanoplasty with mastoidectomy for advanced cholesteatoma. Otolaryngol Head Neck Surg 2000; 29:270.
- 13. Stankovic M. Follow-up of cholesteatoma surgery: open versus closed tympanoplasty. ORL 2007;69: 299-305.
- 14. Roden D, Honrubia, VF, Wiet R. Outcome of residual cholesteatoma and hearing in mastoid surgery. J Otolaryngol 1996; 25:178-81.
- 15. Nyrop M, Bonding P. Extensive cholesteatoma: longterm results of three surgical techniques. The J Laryngology & Otology 1997;111:521-6.
- 16. de Azevedo AF, de Castro Soares AB, Garchet, HQC, de Sousa, NJA. Tympanomastoidectomy: Comparison between canal wall-down and canal wall-up techniques in surgery for chronic otitis media. Int Arch Otorhinolaryngol 2013;17:242-5.
- 17. Kim MB, Choi J, Lee JK et al. Hearing outcomes according to the types of mastoidectomy: a comparison between canal wall up and canal wall down mastoidectomy. Clin Exp Otorhinolaryngo 2010; 3:203.
- 18. Can İH, Metin M, Bayız Ü et al. Sınırlı kolestoatoma tedavisinde uygulanan “Canal Wall-Up” tekniğinin etkinliğinin ikincil gözlem cerrahisi ile değerlendirilmesi (The evaluation of the efficacy of Canal Wall Up procedure for limited cholesteatoma by second look procedure). Dirim Tıp Gazetesi 2011;86:1-5
- 19. Gyo K, Goode RL, Miller C. Effect of middle ear modification on umbo vibration: human temporal bone experiments with a new vibration measuring system. Otolaryngol Head Neck Surg 1986;112:1262-8.