Evaluation of Tympano-Mastoid Surgery for Controlling Infection in active Chronic Suppurative Otitis Media with Cholesteatoma/ A Follow-up Study

  • Qaysar Abdulwahhab Suker MBChB, FACMS in Otolaryngology, Thiqar Health Department
  • Majid Jalil Radhi MBChB, FICMS, FACMS in Otolaryngology,Thiqar Health Department
  • Yasien Abdritha Ajbara MBChB, HDMAST, Clinical Audiologist & Speech Therapist, Thiqar Health Department

Abstract

Background: Control of infection in chronic suppurative otitis media can be achieved by performing surgical techniques as well as medical treatment can be beneficial. Persistent otorrhoea and/or occasionally hearing impairment can be relatively reduced by surgical technique. Although several surgical techniques exist for the treatment of chronic suppurative otitis media, the procedure is selected based on the audiological finding, surgeon experience, and extent of disease. Patients & Methods: A prospective study was performed within eight months. Thirty-four patients included (24 males &10 females); age range was (9-40 years), with chronic suppurative otitis media attended Otolaryngology Department for surgery. A thorough history and examination, audiological, laboratory & radiological investigations were recorded & analyzed. Ear drops and antibiotics were given to all patients before and after surgery. All included patients underwent tympano-mastoidectomy; 11 cases (5 males and 6 females) by intact canal wall technique & 23 cases (19 males and 4 females) by canal wall down technique with follow up 8 months& data recorded& analyzed.    Results:  -Through a period of 8 months all patients were followed up in scheduled visits at 1st week, 1st month, 3rd months, 6th months & 8th month postoperatively. -The overall satisfactory control was achieved in 23patients (67.6%) who have dry ears, while 11patients (32.4%) remained with wet ears. -Out of 23 patients with dry ears, 19(55.8%) patients have cholesteatoma & 4(11.8%) patients have active mucosal disease. -The canal wall down (modified radical) technique was performed in 23 patients & resulted in 18(78.3%) patients having dry ears (15patients have cholesteatoma &3patients had the active mucosal disease), while the other 5(21.7%) patients remained with wet ears (2patients have cholesteatoma&3patients have an active mucosal disease).  -The intact canal wall technique was performed in 11(32.4%) patients & resulted in 5(45.5%) patients having dry ears (4patients have cholesteatoma &1patient had active mucosal disease), while the other 6(54.5%) patients remained with wet ears (all of them have an active mucosal disease). Conclusion  -It is evident that surgery performed in patients with chronic suppurative otitis media gives better chance for control infection. -Canal wall down technique is effective in the treatment of chronic suppurative otitis media with or without cholesteatoma - Cholesteatoma (55.8%) did significantly better than chronic mucosal disease (11.8%)

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Published
2022-08-31
Section
Articles