Timpanoplasti sonrası kulağın protüzyonu ve mastoid sargı kullanımı

Amaç: Bu çalışmada ameliyat sonrası mastoid sargılı ve sargısız timpanoplasti ve timpanomastoidektominin olası yara yeri komplikasyonları değerlendirildi.Hastalar ve Yöntemler: Bu prospektif, randomize kontrollü çalışmaya postauriküler insizyon ile orta kulak veya mastoid cerrahisi yapılan toplam 37 hasta 22 kadın, 15 erkek; ort. yaş: 23.88 yıl; dağılım 9-64 yıl alındı. Hastalar mastoid sargılı n=17 ve mastoid sargısız n=20 olmak üzere iki gruba ayrıldı. Yakın takip ile ameliyat sonrası komplikasyonlar kaydedildi ve mastoid kafa derisi ile auriküler rim arasındaki mesafe ölçüldü.Bulgular: Mastoid sargısız grubun ortalama mastoid heliks mesafesi ameliyat edilen kulaklarda 17.2 mm, ameliyat edilmeyen kulaklarda 16.9 mm olarak bulundu. Mastoid sargılı grubun ortalama mastoid heliks mesafesi ameliyat edilen kulaklarda 15.53 mm ve ameliyat edilmeyen kulaklarda 16.47 mm idi. Yalnızca bir hastada ciltte eritem görüldü. Mastoidheliks arası mesafede istatistiksel olarak anlamlı bir artış bulunmadı p>0.05 .Sonuç: Mastoidektomili veya mastoidektomisiz timpanoplasti mastoid sargı kullanılmasa da, ameliyat sonrası komplikasyona veya kulağın protrüzyonuna yol açmamaktadır. Çalışma bulgularımız mastoid sargının mastoidektomili veya mastoidektomisiz timpanoplasti sonrası herhangi bir yararı olmadığını göstermektedir

Ear protrusion after tympanoplasty and the use of mastoid dressing

Objectives: This study aims to assess possible wound complications of tympanoplasty and tympanomastoidectomy with or without postoperative mastoid dressing. Patients and Methods: A total of 37 patients 22 females, 15 males; mean age: 23.88 years; range 9 to 64 years who underwent middle ear or mastoid operations via postauricular incision were included in this prospective, randomized, controlled study. The patients were divided into two groups as having mastoid dressing n=17 and nonmastoid dressing n=20 . Through a close follow-up, postoperative complications were noted and distance from mastoid scalp and auricular rim was measured. Results: The mean mastoid-helix distance of non-mastoid dressing group was found 17.2 mm in operated and 16.9 mm in non-operated ears. The mean mastoid-helix distance of mastoid dressing group was 15.53 mm in operated ears and 16.47 mm in non-operated ears. Skin erythema was seen in a patient. There was no statistically significant increase in mastoid-helix distance p>0.05 . Conclusion: Tympanoplasty with or without mastoidectomy does not cause postoperative complication or protrusion of the ear, even if no mastoid dressing is used. Our study results suggest no benefit of mastoid dressing after tympanoplasty with or without mastoidectomy.

___

  • Rowe-Jones JM, Leighton SE. The value of head dressings for middle ear surgery. J Laryngol Otol 1993;107:17-9.
  • Orabi AA, Chintamani BH, Timms MS. Is a head bandage useful after otoplasty? A quasi-randomized controlled study of complications and patient satisfaction. Ear Nose Throat J 2009;88:E17-22.
  • Castelli ML, Di Lisi D, Marcato P, Tavormina P, Cappellaro E, Sartoris A. Is pressure dressing necessary after ear surgery? Ann Otol Rhinol Laryngol 2001;110:254-6.
  • Kalcioglu MT, Miman MC, Toplu Y, Yakinci C, Ozturan O. Anthropometric growth study of normal human auricle. Int J Pediatr Otorhinolaryngol 2003;67:1169-77.
  • Marshall DA, Mertz PM, Eaglstein WH. Occlusive dressings. Does dressing type influence the growth of common bacterial pathogens? Arch Surg 1990;125:1136-9.
  • Luo SD, Su CY, Wu CM, Hwang CF. Mastoid pressure dressing for cochlear implantation--is it necessary? Int J Pediatr Otorhinolaryngol 2009;73:857-60.
  • Rhŷs Evans PH. Knot to be condemned. J Laryngol Otol 1993;107:33-4.
  • Demir Y, Yilmaz MD, Haktanir N. Dangers of a tight head dressing. Aesthetic Plast Surg 2004;28:256.