SEARCH · PubMed Health

Results for “MASTOID SURGERY”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 163 records · Page 9Linked to original sources

PubMed1997

The Singapore swing.

The use of a rotation pedicled flap, entitled the 'Singapore Swing', comprising temporalis fascia and mastoid periosteum, is presented as a new method of promoting healing in 'open' mastoid surgery for chronic ear discharge. Cadaver studies show that the main blood supply of the flap is derived from a branch of the postauricular artery which enters the pedicle near the mastoid tip. A review of the first 14 operations showed complete healing with dry ears and intact tympanic membranes in all instances, three cases requiring secondary grafting of residual perforations. We consider the results sufficiently encouraging to merit an extended trial of the technique.

Cholesteatoma↗

PubMed1991

Meningitis from canine Pasteurella multocida following mastoidectomy.

A case of Pasteurella multocida meningitis, following a mastoidectomy is presented. The association of close contact with pets, many of which harbour Pasteurella multocida as part of their normal buccal flora. This case confirms the potential benefit of taking an ear swab prior to mastoid surgery and in seeking an appropriate 'pet' history.

Adult↗

PubMed1989

Dimensions of the extended facial recess.

The variability of the dimensions of the facial recess and extended facial recess with age, sex, and degree of pneumatization was measured in 87 temporal bones serially sectioned in the horizontal plane. Although some statistically significant differences in dimensions were identified, the absolute differences were small compared to the range of measurements. The mean dimensions were very similar in all groups studied. The clinical relevance of the data to mastoid surgery and cochlear implantation is discussed.

Adult↗

PubMed2003

Management of cholesteatoma: status of the canal wall.

OBJECTIVE/HYPOTHESIS: Management of chronic otitis media with cholesteatoma remains controversial. The purpose of the study is to examine factors associated with the surgical approach to manage cholesteatoma. STUDY DESIGN: A retrospective review. METHODS: A retrospective review was made of all primary cases of mastoid surgery for cholesteatoma performed at an otological center between 1995 and 2000. During the study period, 486 ears underwent surgery for cholesteatoma. Data included procedures performed, location and extent of the disease, residual and recurrent disease, complications, reasons for staging the surgery, and duration of follow-up. RESULTS: The canal wall remained intact in 68.5% of ears. The majority of the remainder of the patients underwent a canal wall down technique with mastoid obliteration. Residual cholesteatoma was found in 26.9% of second procedures and in 2.7% of third procedures. CONCLUSIONS: The majority of patients with cholesteatoma can be adequately managed with a canal intact tympanomastoidectomy with staging. Otolaryngologists should consider a two-staged procedure as a viable management approach for chronic otitis media with cholesteatoma.

Adolescent↗

PubMed1978

Tragal perichondrium and cartilage in reconstructive ear surgery.

Two hundred and fifty-five ear operations using tragal perichondrium and cartilage for reconstruction are presented. Of these, 108 were myringoplasties, 137 were tympanoplasties with ossicular reconstruction performed by nine different methods, and 10 were tympanoplasties with reconstruction of posterior canal wall defects left by radical mastoid surgery. The method presented in this study of using the tragal perichondrial graft is well suited for myringoplasty and can be used where the drum remnant is very small or the anulus is missing. The natural angle of the tragal perichondrium can take the place of the missing anulus anteriorly, inferiorly or posteriorly. Myringoplasty graft survival at one year follow-up was 92%, and 76% had hearing within 10 db of bone conduction. In tympanoplasty, the tragal perichondrium was used en bloc with its cartilage for reconstruction of the ossicular chain where suited. The malleus was used to reconstruct the ossicular chain in different variations. Other methods used are fully described. At one year follow-up the rate of grafting success for tympanoplasties was 91%, and 78% had hearing within 10 db of bone conduction. A method for reconstruction of the posterior canal wall and tympanoplasty after radical mastoidectomy is presented. It uses tragal cartilage and perichondrium en bloc. At one year follow-up, eight of ten cases operated on by this method had an intact drum and posterior canal wall, one had an intact drum but the posterior canal collapsed into the mastoid, and one had an intact canal wall but the eardrum re-perforated. Nine had postoperative hearing within 10 db of bone conduction. A randomly selected group of 100 tympanoplasties was examined for postoperative gain in hearing according to the speech reception threshold, a more practical criterion of surgical success than 10 db air-bone gap. Although the total number showing improvement was similar to the number gaining hearing within 10 db of pure tone bone conduction (76% vs. 78%), when changes of 5 db were discounted, only 56% were improved (and 33% had a significant gain in hearing).

Adult↗

PubMed2006

Reduction meatoplasty with a post-auricular island flap.

The importance of an adequate meatoplasty is often emphasised in mastoid surgery. However, bigger is not always better, as an excessively widened external meatus can be cosmetically unacceptable, provide little extra benefit for cleaning, be an obstacle to the good fitting of hearing aids and expose the mastoid cavity to exaggerated caloric effect. The problems created by an overly large meatus can occasionally be difficult to manage, prompting consideration of reduction of the meatus. We describe the use of a pedicled, post-auricular skin flap to achieve reduction of an excessively large meatus.

Ear Deformities, Acquired↗

PubMed1999

A technique of mastoidectomy and meatoplasty that minimizes factors associated with a discharging mastoid cavity.

OBJECTIVES: To present and assess a surgical technique designed to minimize the known causes of a discharging mastoid cavity. STUDY DESIGN: A temporal bone dissection to establish the anatomical relationships on which the surgical technique is based. A presentation of the proposed surgical technique and a prospective assessment of the technique in twenty consecutive mastoidectomies. METHODS: Five temporal bone dissections were performed to establish the relationship between the chorda tympani and the facial nerve when these structures are approached from above. The surgical technique is presented and the mastoid cavities of twenty consecutive patients assessed. The assessment included measurement of the facial ridge height, "kidney-shape" of the cavity, size of the cavity, size of the meatus, and state of the tympanic membrane. RESULTS: In the temporal bone dissections the vertical height between the chorda tympani and the facial nerve at 3/9 o'clock was a mean of 2.01 mm. Nineteen of the 20 consecutive mastoid cavities (95%) performed with the presented technique remained well healed and dry. The mean facial ridge height was 2.7 mm at 3/9 o'clock and 4.8 mm at 6 o'clock. The kidney-shaped measurement was 1.45 mm. The mean size of the cavities was 2.6 mm and 18 of the 20 patients (90%) had an intact tympanic membrane. The mean largest diameter of the meatus was 10.1 mm. CONCLUSIONS: The surgical technique presented produces a mastoid cavity with a low facial ridge and oval shape. These two factors have been previously identified as important in the outcome of mastoid surgery.

Adolescent↗

PubMed1998

Acute otitis media: the evolution of surgical management.

OBJECTIVE: Acute suppurative otitis media has been a common disease since time immemorial and, until the late nineteenth century, was followed by a high complication rate, major morbidity, and frequent mortality. Since then, the overall incidence of the disease has changed little; however, in less than a century, progressively more sophisticated surgery and the introduction of antimicrobials have reduced the mortality, at least in developed countries, to a rarity. Complications such as chronic perforation of the tympanic membrane or cholesteatoma, although much less frequent than in the past, are not uncommon. The evolution of mastoid surgery into the antibiotic era is reviewed. CONCLUSION: There is concern that with the increasing frequency of bacterial resistance to antibiotics and the decreasing familiarity of family practitioners with the clinical presentation of complicated otitis media that we may be faced with a resurgence of mastoid disease.

Acute Disease↗

PubMed1992

Results of surgical treatment for chronic noncholesteatomatous otitis media in the pediatric population.

The long-term results of surgery for chronic otitis media without cholesteatoma were analyzed in 76 ears of children aged 16 years or less. The mean follow-up period was 6.0 years. Thirty-four ears were subjected to mastoid surgery for chronic otorrhea; at final follow-up examination the disease was found to be cured in all but one patient. Forty-two patients with sequelae to chronic otitis media underwent tympanoplasty without mastoidectomy which was successful in 38 (91%) of these. At follow-up, 84% of the patients had hearing levels of 20 dB or better. Outcome of surgery and hearing results in children were as good as or even better than those obtained in adult patients. Complications of surgery were rare.

Adolescent↗

PubMed1990

Endaural meatoplasty for mastoid cavities.

Obtaining an adequate meatoplasty when performing mastoid surgery via an endaural approach is not always easy. This paper reviews the different types of meatoplasty available and describes a transposition flap of pretragal skin which can be used to provide a meatoplasty for mastoid cavities, acquired stenosis or congenital stenosis.

Ear, External↗

PubMed1997

The use of Indermil (n-butyl cyanoacrylate) in otorhinolaryngology and head and neck surgery. A preliminary report on the first 33 patients.

The authors present their initial experience of a new sterile medical grade cyanoacrylate adhesive (Indermil) in otolaryngeal and head and neck surgery. Thirty-three patients who underwent a variety of head and neck operations consented to have their skin incisions closed using the adhesive and 10 of those also underwent repair of the tympanic membrane, either as part of tympanoplasty or mastoid surgery. The history of the use of this class of adhesive is presented with an explanation of the chemical properties of these compounds. Advantages of using cyanoacrylate adhesives and future possible applications in otolaryngology and head and neck surgery are discussed.

Drug Delivery Systems↗

PubMed2000

Brain herniation and chronic otitis media: diagnosis and surgical management.

Herniation of the brain into the middle ear is a rare, but potentially life-threatening complication of chronic otitis media. Fifty patients with a tegmen defect associated with chronic otitis media were operated on between 1985 and 1998. Among these 50, 15 patients presented brain herniation associated with the bony defect. Fourteen patients had undergone previous mastoid surgery for chronic otitis media. Neurological symptoms were encountered in five patients. In 10, magnetic resonance imaging (MRI) was performed before surgery, and a diagnosis of brain herniation could be made. The hernia was repaired in all patients using a middle fossa craniotomy, combined with a transmastoid approach in 11 cases where a large hernia, and/or inflammatory tissues were present in the mastoid. The herniated brain tissue was resected in all, and the dural and bony defects were closed with fascia and bone. No complication or recurrence occurred, during a mean follow-up of 2 years. In conclusion, the occurrence of severe neurological complications as a consequence of brain herniation emphasizes the necessity for recognition and appropriate management of this disease. Computerized tomography (CT) scanning allows the suspicion of brain herniation, but a definitive diagnosis can best be established with an MRI study. The hernia should be repaired using a middle fossa craniotomy, combined with a transmastoid approach in one or two stages, when necessary.

Adult↗

PubMed2002

Postmastoidectomy pneumocephalus: case report.

Chronic otitis media, unlike trauma, seldom leads to the development of tension pneumocephalus. Rarely, it occurs as a complication of mastoid surgery. A Melanesian woman sought treatment for loss of speech, hemiparesis, and headache 4 weeks after undergoing canal-down mastoidectomy for cholesteatoma. The tension pneumocephalus was decompressed urgently by aspirating air via a cannula through the burr hole, and the mastoid cavity was obliterated. She recovered completely. Twelve additional patients with postmastoidectomy pneumocephalus reported in the literature are reviewed.

Case Reports↗

PubMed1999

Hydroxyapatite canal wall reconstruction/mastoid obliteration.

The controversy regarding removal of the posterior external canal wall during mastoid surgery spans many decades. There are inherent advantages and disadvantages to either removing or not removing the canal wall. The operation must be tailored to the patient and his or her unique situation. We describe our experience with external canal wall reconstruction and mastoid obliteration with hydroxyapatite in an effort to derive the best of both philosophies. Hydroxyapatite has been used in 3 different forms including granules, a preformed canal wall prosthesis, and with a block of hydroxyapatite sculpted to fit the individual defect. A total of 36 patients with up to 54-month follow-up are reported. Details of the techniques used, with advantages and pitfalls, are described.

Adolescent↗

PubMed1990

Risks of developing an otogenic intracranial abscess.

One-and-a-half per cent of adults have active chronic otitis media and its management to prevent complications is a considerable workload. The risks of developing these complications is relatively unknown but because of its mortality, intracranial abscess is the most relevant. A 10-year review of all otogenic intracranial absesses in Scotland was carried out. A 15 per cent allowance was made for missing records. The annual risk in an adult with active chronic otitis media of developing an abscess is about one in 10,000 but its development is three times more likely in males. This risk might appear low but the lifetime expectancy of an individual aged 30 years with active chronic otitis media developing an abscess is one in 200. However, as yet, there is no evidence that surgery reduces this risk. Unfortunately, because of the duration of follow-up needed and the size of the sample required, scientific evidence would be difficult to obtain. However, 5 per cent of abscesses currently occur in the immediate post-operative period following mastoid surgery.

Adolescent↗

PubMed2003

Live recordings of sound levels during the use of powered instruments in ENT surgery.

Otolaryngology is one of the surgical specialities employing high-powered instruments and this study was designed in order to establish whether sound levels at work conform to HSE guidelines. No study to date has measured intra-operative noise levels in ENT operation theatres. A prospective observational study was therefore performed. Sound levels were measured during the use of bone drills for mastoid surgery and microdebriders for endoscopic sinus surgery. A SLM/IS Acos Class I sound level meter calibrated to BS 1259 was employed. A spectrum analysis of drill-generated noise was measured using a calibrated B and K precision sound level meter. Sound levels emitted varied as follows: Large burrs- 72.4 dB (A), medium size; 71.2 dB (A), small sized burrs- 68.8 dB (A) (all values for cutting burrs) and 60.8 dB (A) for diamond burs. With microdebriders, the average sound level was 60.1 dBA. Spectrum analysis revealed that the maximum intensity was at 3.15 kHz, followed by 4 kHz, while the least sound was produced at 40 kHz and 31.5 kHz. Essentially sound produced by drills was between 1.6 kHz and 6.3 kHz. Powered instruments used in ENT surgery are safe and pose no occupational hazard.

Humans↗

PubMed2003

Delayed labyrinthine fistula in canal wall down mastoidectomy.

PURPOSE OF THE STUDY: This article is a retrospective review of 5 cases of delayed labyrinthine fistula in patients with a longstanding canal wall down mastoidectomy. MATERIAL: All patients had a long-term postoperative follow up with no evidence of complications till they suddenly started to have vertigo. The symptoms were caused by a bony erosion of the lateral semicircular canal detected on physical examination or by a CT-scan. There was no evidence of a recurrent cholesteatoma. RESULTS: The patients underwent surgery in order to close the fistula, with a good result. In all cases, a factor such as an infection or trauma, seems to have triggered off the bone erosion. CONCLUSION: Late complications may occur in the canal wall down mastoidectomy technique, after a long period of follow up in the absence of recurrent cholesteatoma. For this reason, it is advisable to look for a labyrinthine fistula in patient who develop vertigo a long time following mastoid surgery with a resultant radical cavity.

Aged↗

PubMed1979

Combined otoneurosurgical approach to patients with chronic ear disease and cerebrospinal otorrhea.

We report a combined otoneurosurgical approach in the treatment of a patient with meningitis due to an arachnoid cyst, extending through the dura and petrous bone into the middle ear. The combination of mastoid surgery and temporal craniotomy including opening the dura was necessary to determine the nature of the problem, excise the disease and repair the defects. Two recent cases at our Institution of cerebrospinal otorhinorrhea and chronic ear disease illustrate the difficulty in carrying out definitive repair of dural defects from within the mastoid cavity. Case 2 had three bouts of meningitis and two brain abscesses separated by 25 years. Case 3 had eight bouts of meningitis in 19 years. The authors recommend at otoneurosurgical team approach in patients with cerebrospinal otorhinorrhea permitting treatment of the temporal bone, dura and brain.

Cerebrospinal Fluid Otorrhea↗