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At least 91 records · Page 5Linked to original sources
PubMed1991

The effect of mastoid surgery on atelectatic ears and retraction pockets.

Forty children and 53 adults with a total of 111 atelectatic ears were operated on and followed up. Eight-four ears underwent tympanoplasty, while 27 ears underwent both a tympanoplasty and a mastoid operation. There were no statistically significant differences between the two operation groups as far as their age groups and the extent of the disease present. After follow-up of over 4 years, aeration of the middle ear was found to be better in the tympanoplasty group alone when compared with ears with also had mastoid operations.

Adolescent↗
PubMed2005

Objective assessment of the perineural vascular plexus as a landmark for the horizontal part of the facial nerve in middle ear and mastoid surgery.

OBJECTIVE: To objectively evaluate the usefulness and the reliability of the perineural vascular plexus as a landmark for identification of the facial nerve in surgery for chronic squamous otitis media. STUDY DESIGN: Prospective case series. SETTING: Tertiary otologic center. PATIENTS: Seventy consecutive patients requiring surgery for cholesteatomatous otitis media. INTERVENTION: Use of a semiquantitative grading system intraoperatively to assess the utility and ease of using the perineural facial plexus as the pointer to the facial nerve. MAIN OUTCOME MEASURES: Description of the perineural vascular plexus and assessment of the reproducibility of the grading system. RESULTS: In 82.5% of patients, the plexus was used as the sole pointer to the level of the facial nerve, with other landmarks being used in the remaining 17.5%. A very prominent vessel was used to identify the nerve in 82.5%, therefore being classified as Grade 1. Multiple small vessels were seen in 15.8% (Grade 2), and in 1.5% the vessel plexus was thin and difficult to identify. The average measure intraclass correlation was 0.75 (95% confidence interval, 0.57-0.85), indicating excellent reproducibility of the system. CONCLUSION: We believe that the perineural vascular plexus is a dependable and reliable landmark for the level of the facial nerve in surgery for chronic otitis media.

Cholesteatoma, Middle Ear↗
PubMed1982

Assessment of postoperative hearing in 528 middle ear and mastoid surgery cases in Tokai University Hospital.

The postoperative hearing results in cases of tympanoplasty, radical mastoidectomy, modified radical mastoidectomy and tympanoplasty combined with modified radical mastoidectomy on 528 ears, performed in the Tokai University Hospital between 1975 and 1980 were assessed. The assessment was based on pure-tone audiograms taken 3 months to 5 years after the operation. Out of 528 cases 70.5% gained better postoperative hearing, 6% showed no change of hearing and 23.5% showed deterioration of hearing. Auditory success of those who attained social hearing, air-bone gap closure to within 20dB or gained hearing of 20 dB or more was 53.4%. The results in cholesteatoma cases were poorer than those of non-cholesteatoma cases. In 44% of the cases, ossiculoplasty was performed, and the most successful ossiculoplasty results were obtained when the malleus was repositioned to the head of the stapes. Fairly good results were achieved when an artificial prosthesis, such as a Teflon-piston, Gelfoam-wire or platinum-piston, was used. The least successful results were found when the incus was transpositioned. In the non-ossiculoplasty group, type I tympanoplasty produced 59.5% auditory success whereas 37.3% auditory success was achieved in radical mastoidectomy. Better auditory success rates were obtained when the bony bridge was preserved than when it was removed. The results were identical in cases where the mastoid cavity was obliterated or when it was kept open. A new technique, "scutumplasty", was used for reconstructing the scutum. Revision surgery was required in only 3.4% of the cases.

Hearing↗
PubMedDate not supplied

[The mastoid surgery in children at the Doce de Octubre Hospital. Review of the years 1988-1991].

A study was made of 21 children with cholesteatoma and chronic otitis media between 1989 and 1991. We reviewed diagnostic tools, presurgical data, surgical procedures and results. Certain aspects of special relevance such as congenital anomalies and presurgical complications, are emphasized. The procedure of choice was mastoid tympanoplasty with the canal wall down, which is preferred in children. Hearing results were poor, partially caused by the process of bone resorption and by the surgical technique used. The incidence of persistent disease and recurrent cholesteatoma was high but we achieved a good control of the disease development because the canal wall down procedure allowed visualization and cleaning of the mastoid cavity.

Adolescent↗
PubMed2006

Traumatic facial nerve neuroma following mastoid surgery: a case report and literature review.

Traumatic facial nerve neuroma is rare. There are only 10 reported cases in the literature, caused either by physical trauma or chronic inflammation. Traumatic facial neuromata differ from true facial nerve neoplasms in radiological, macroscopic and microscopic appearance, but clinical presentation is less reliable in differentiating the two. Management depends on the pre-operative grade of facial palsy, as this is a benign condition and surgical management carries a risk of further affecting facial nerve function. We present a further case of traumatic facial nerve neuroma following surgery for cholesteatoma. We also review the literature and discuss the management of this condition.

Adult↗
PubMed2004

[The observation of delayed facial paralysis after middle ear and mastoid surgery: 10 cases analysis].

OBJECTIVE: To analyze the cause,treatment and prognosis of 10 cases (ten ears) of delayed facial paralysis (DFP) after chronic otitis media surgery. METHOD: Ten cases of DFP after chronic otitis media surgery were reviewed for the causes, treatments and their prognosis. In all 10 cases, glucocorticoid, antibiotics, neurotrophic and blood vessel dilating agents were prescribed and physiotherapy was also applied. RESULT: After 3 weeks, full recovery was found in all cases, showing the benign prognosis of DFP after chronic otitis media surgery. CONCLUSION: The local edema of facial nerve in response to minor surgical procedures is speculated to be the primary cause of DFP, and it may also be accelerated by the infections of herpes simplex subsequently.

Adolescent↗
PubMed1992

Detection of recurrent cholesteatoma by computerized tomography after 'closed cavity' mastoid surgery.

Pre-operative Computerized Tomography was performed prior to second look operations in 10 cases to check for cholesteatoma after combined approach tympanoplasty. Three independent opinions were obtained on the CT scans and compared with the operative findings. This small series failed to demonstrate reliable pre-operative radiological detection of cholesteatoma. There was disappointing inter-observer agreement in interpretation of the CT scans.

Cholesteatoma↗
PubMed1984

Potential complications of unrecognized cerebrospinal fluid leaks secondary to mastoid surgery.

Unrecognized cerebrospinal fluid (CSF) drainage from a dural tear created during mastoidectomy rarely occurs, but when it does the consequences may be catastrophic. The potential complications discussed in this article are CSF otorrhea, meningitis, pneumocephalus, and hydrocephalus. The pathophysiology and diagnosis of these complications are individually discussed. The medical management and surgical procedures required to treat such complications are reviewed using a case presentation as an illustration. In addition, a flow sheet detailing the interrelationship between these potential complications and their treatment is outlined.

Cerebrospinal Fluid Otorrhea↗
PubMed1993

[Pneumocephalus as a complication of mastoid surgery].

Non-traumatic otologic diseases are a rare cause of Pneumocephalus. Among them few reports have been published whereas it presented following oto-surgery. The AA. communicate one of those events in a patient who presented with CSF-otorrhea, headache and disorientation after recent radical mastoidectomy. The definitive diagnosis was done by CT-scan imaging. Survey of the scarce literature on the subject, description of the clinical and diagnostic features, its possible physiopathology and surgical management.

Aged↗
PubMed1994

Toynbee Memorial Lecture 1994: mastoid surgery and the Hong Kong Flap.

Critical evaluation of the outcome of surgery for cholesteatoma has favoured open cavity techniques. These methods have however been plagued by an inability to consistently produce healthy well healed cavities. The strength and stability of the normal tympanic membrane depends upon the separation of squamous epithelium from the middle ear mucosa by a fibrous tissue layer. Traditional methods of dealing with the cavity fail to reproduce a similar anatomically stable arrangement. In order to achieve the highest percentage of dry, stable disease-free ears after employing basic surgical principles of wide access to facilitate meticulous removal of all cholesteatoma, we have utilized a vascularized deep temporalis fascia flap for complete coverage of the cavity eliminating all raw areas. This fibrous layer provides the optimal substrate for epithelial resurfacing. Excellent healing even under unfavourable circumstances is ensured by the rich blood supply to the pedicled temporalis fascia flap. Considering patient preferences and cost effectiveness, the optimal treatment for cholesteatoma must be one operation, provided it achieves a dry safe ear. Based upon rational concepts, the 'Hong Kong Flap' technique of reconstructing the mastoid cavity involves a straightforward procedure requiring no special technical skill that consistently achieves this ideal.

Adolescent↗
PubMed1996

Mastoid surgery in the only hearing ear.

Every otologic procedure carries the risk of damage to the inner ear. On the other hand, cholesteatoma and uncontrolled tubotympanic disease can lead to partial or total sensorineural loss, as well as intracranial complications. Our experience of the surgical management of eight patients with an only hearing ear is presented. There were no dead ears in this series and no significant worsening of inner ear function. The air conduction pure-tone average was worse in two patients without change in bone conduction. Of the eight patients, six wear a hearing aid with success and two patients manage without an aid. The present small series confirms that patients at risk of anacusis from cholesteatoma or chronic suppurative otitis media can be offered, in experienced tertiary referral units, a safe method of stabilizing the ear and preserving useful hearing.

Adult↗
PubMed1995

Evaluation of mastoid obliteration surgery.

The anatomic results of mastoid obliteration surgery on 54 ears during the past 10 years were analyzed, and the comparative utility of several materials for obliteration was evaluated. Thirty-three ears had primary chronic otitis media with or without cholesteatoma (group 1), and 21 ears had old open mastoid with intractable chronic discharge due to incomplete epithelialization (group 2). The materials used for obliteration were biologic (pedicled muscle flap, autogenous bone chips, tragal cartilage with perichondrium, allograft dura), nonbiologic (hydroxyapatite), or a combination of two of these materials. Evaluation at 2 months postoperatively showed that 42 ears were anatomically complete, whereas the other 12 ears were incomplete: three cases in group 1 and nine cases in group 2. The main causes of these unsatisfactory results were exposure of transplanted artificial material or partial loss of the pedicled muscle flap. In the long-term follow-up results, four ears were evaluated as unsatisfactory in group 1, and six ears in group 2, owing to shrinkage of obliterated tissue. The major causes of failure were anatomic incompleteness following surgery for old open mastoid cavity, in which the use of biologic materials for obliteration was much safer than nonbiologic material, and from the protrusion of artificial materials used.

Biocompatible Materials↗
PubMedDate not supplied

Endolymphatic sac-mastoid shunt surgery. A nonspecific treatment modality?

The reason for the effectiveness of endolymphatic sac-mastoid shunt surgery in the treatment of patients with Meniere's disease is still open for debate. In a double-blind study, published in 1981, we could not demonstrate any difference between the effect of a simple mastoidectomy and a regular endolymphatic sac-mastoid Silastic sheet shunt. However, a significant reduction in symptoms could be demonstrated in both groups, and 70% of patients in both groups could be classified as successes. The patients were reexamined 3 years after surgery, and it was still not possible to demonstrate any differences between the sham and the active surgery. In this study, no significant differences between the two groups have been found at follow-up averaging 84 months, and success has been maintained in about 70% of patients. The only three failures, who have consistent vertiginous attacks, have been confined to the actual shunt group. Two patients in the active group have lost their hearing as compared with none in the sham group, and 35% of the patients have now developed bilateral disease. We believe that endolymphatic sac-mastoid shunt surgery is a nonspecific treatment modality, and we find no need for sac shunt surgery. The vast majority of the patients can be successfully treated by nonsurgical means, but we emphasize that above all the patient must be assured that in the event of persistent debilitating symptoms, a surgical solution to the problem is available.

Adult↗
PubMed2002

Major ear surgery in a paediatric day care unit.

Abstract Traditionally major ear surgery in children has been regarded as an in-patient procedure. Evidence from the USA for adults, however, concludes that it is both safe and effective to perform many major ear procedures as day cases. We have been carrying out major ear operations on children as day cases routinely for six years in a dedicated children's day unit and examined our data to find out whether it was both safe and feasible to perform major ear surgery in children on a day-case basis. As our main outcome measure we used the rate of unplanned admissions. We found that the unplanned admission rate for surgery, excluding mastoid surgery, was 6.7 per cent and that procedures such as myringoplasty, ossiculoplasty, bilateral pinnaplasty, meatoplasty and tympanotomy with excision of cholesteatoma, were eminently suitable for day surgery.

Adolescent↗
PubMed1978

Changes in otological teaching following analysis of failures in surgical technique.

An analysis was made of the results of mastoid surgery performed in the Professorial Unit of the Royal National Throat, Nose and Ear Hospital, London, between the years 1970 and 1974. Most of the surgery was performed by trainee surgeons at the end of the teaching programme. The incidence of unsatisfactory results was greater with open mastoid surgery than with closed mastoid surgery. The causes of failure were analysed, and the underlying defects in the teaching programme identified. The subsequent modification in the teaching methods that resulted are illustrated.

Cholesteatoma↗
PubMed1987

Results of endolymphatic sac to mastoid shunt surgery for Menière's disease refractory to medical therapy.

In the ten-year period ending July 1, 1986, 5475 dizzy patients were evaluated and treated medically at the Colorado Ear Clinic. Of these, 214 patients (4%) were diagnosed as having classic Meniere's disease refractory to medical therapy and underwent endolymphatic sac to mastoid shunt surgery. These patients were followed for a minimum of one year after surgery. The average audiometric follow-up was 35.1 months. Based on the American Academy of Otolaryngology-Head and Neck Surgery 1985 criteria for reporting results at one year, 60.3% had lower audiometric thresholds postoperatively (H1) or unchanged thresholds (H2) relative to the worst preoperative audiogram. Elimination of all vertiginous attacks was achieved in 73.9% (Vo). Adjunctive spells were not assessed. Disability was eliminated (Do) in 86%. Based on a prospective computerized analysis of forty pertinent variables, a profile of a classic Meniere's disease patient who has failed to improve with medical, allergic, dietary, exercise, or other conservative treatment and would be likely to benefit from endolymphatic sac to mastoid shunt surgery is established.

Adolescent↗