Air space reduction tympanomastoidectomy repairs difficult perforations more reliably than tympanoplasty
Objectives/Hypothesis Air space reduction tympanomastoidectomy improves outcomes over tympanoplasty in repairing tympanic membrane perforations in the presence of unfavorable risk factors. Study Design Retrospective review of 67 subjects' 87 operations. Methods Interventions were tympanoplasty...
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| Veröffentlicht in: | The Laryngoscope 2014-06, Vol.124 (S3), p.S1-S13 |
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| container_title | The Laryngoscope |
| container_volume | 124 |
| creator | Redleaf, Miriam I. |
| description | Objectives/Hypothesis
Air space reduction tympanomastoidectomy improves outcomes over tympanoplasty in repairing tympanic membrane perforations in the presence of unfavorable risk factors.
Study Design
Retrospective review of 67 subjects' 87 operations.
Methods
Interventions were tympanoplasty versus air space reduction tympanomastoidectomy. Risk factors were contracted mastoid air cells, previous failed operations, descent from the indigenous peoples of the Americas, and middle/ear mastoid volumes l |
| doi_str_mv | 10.1002/lary.23599 |
| format | Article |
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Air space reduction tympanomastoidectomy improves outcomes over tympanoplasty in repairing tympanic membrane perforations in the presence of unfavorable risk factors.
Study Design
Retrospective review of 67 subjects' 87 operations.
Methods
Interventions were tympanoplasty versus air space reduction tympanomastoidectomy. Risk factors were contracted mastoid air cells, previous failed operations, descent from the indigenous peoples of the Americas, and middle/ear mastoid volumes l<3 CC. Favorable outcomes were closure of the perforation, no decline in hearing, and creation of a self‐cleaning mastoid bowl.
Results
Five out of 46 air space reduction tympanomastoidectomies failed to close their perforations (11%). Pure‐tone threshold (PTA) worsened in 13/46 ears (28%). Four of 46 required mastoid bowl cleaning (9%). In contrast, 21 of 41 tympanoplasties failed to close (51%). PTA worsened in 9/34 ears (26%). All four tympanoplasty failures treated with an air space reduction tympanomastoidectomy closed. Three of the seven tympanoplasty failures treated with a second tympanoplasty did not close. Statistical analysis found two risk factors more prevalent among the air space reduction tympanomastoidectomies: contracted mastoids (P = .019) and middle ear volumes <3 CC (P = .0001). Increased closure of perforations occurring after the air space reduction tympanomastoidectomy was also statistically significant (P = .0002). Descendants of indigenous peoples of the Americas trended toward better PTAs after their air space reduction tympanomastoidectomies than their tympanoplasties and showed statistically significant increases in closure of perforation (P = .0046).
Conclusions
Air space reduction tympanomastoidectomy is an effective and safe method for closing tympanic membrane perforations. © 147.
Level of Evidence
Level of Evidence: 2b Laryngoscope, 124:S1–S13, 2014</description><identifier>ISSN: 0023-852X</identifier><identifier>EISSN: 1531-4995</identifier><identifier>DOI: 10.1002/lary.23599</identifier><identifier>PMID: 23553170</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Audiometry, Pure-Tone ; Child ; Child, Preschool ; Humans ; Mastoid - surgery ; mastoidectomy ; Middle Aged ; Retrospective Studies ; Risk Factors ; Treatment Outcome ; Tympanic Membrane - surgery ; tympanic membrane perforation ; Tympanic Membrane Perforation - surgery ; tympanoplasty ; Tympanoplasty - methods ; Young Adult</subject><ispartof>The Laryngoscope, 2014-06, Vol.124 (S3), p.S1-S13</ispartof><rights>Copyright © 2013 The American Laryngological, Rhinological, and Otological Society, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4289-72f853281bc9bf1cd5b6f24d8b3c74894811b257c08510020b149a05c1962ac83</citedby><cites>FETCH-LOGICAL-c4289-72f853281bc9bf1cd5b6f24d8b3c74894811b257c08510020b149a05c1962ac83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Flary.23599$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Flary.23599$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23553170$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Redleaf, Miriam I.</creatorcontrib><title>Air space reduction tympanomastoidectomy repairs difficult perforations more reliably than tympanoplasty</title><title>The Laryngoscope</title><addtitle>The Laryngoscope</addtitle><description>Objectives/Hypothesis
Air space reduction tympanomastoidectomy improves outcomes over tympanoplasty in repairing tympanic membrane perforations in the presence of unfavorable risk factors.
Study Design
Retrospective review of 67 subjects' 87 operations.
Methods
Interventions were tympanoplasty versus air space reduction tympanomastoidectomy. Risk factors were contracted mastoid air cells, previous failed operations, descent from the indigenous peoples of the Americas, and middle/ear mastoid volumes l<3 CC. Favorable outcomes were closure of the perforation, no decline in hearing, and creation of a self‐cleaning mastoid bowl.
Results
Five out of 46 air space reduction tympanomastoidectomies failed to close their perforations (11%). Pure‐tone threshold (PTA) worsened in 13/46 ears (28%). Four of 46 required mastoid bowl cleaning (9%). In contrast, 21 of 41 tympanoplasties failed to close (51%). PTA worsened in 9/34 ears (26%). All four tympanoplasty failures treated with an air space reduction tympanomastoidectomy closed. Three of the seven tympanoplasty failures treated with a second tympanoplasty did not close. Statistical analysis found two risk factors more prevalent among the air space reduction tympanomastoidectomies: contracted mastoids (P = .019) and middle ear volumes <3 CC (P = .0001). Increased closure of perforations occurring after the air space reduction tympanomastoidectomy was also statistically significant (P = .0002). Descendants of indigenous peoples of the Americas trended toward better PTAs after their air space reduction tympanomastoidectomies than their tympanoplasties and showed statistically significant increases in closure of perforation (P = .0046).
Conclusions
Air space reduction tympanomastoidectomy is an effective and safe method for closing tympanic membrane perforations. © 147.
Level of Evidence
Level of Evidence: 2b Laryngoscope, 124:S1–S13, 2014</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Audiometry, Pure-Tone</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Humans</subject><subject>Mastoid - surgery</subject><subject>mastoidectomy</subject><subject>Middle Aged</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Treatment Outcome</subject><subject>Tympanic Membrane - surgery</subject><subject>tympanic membrane perforation</subject><subject>Tympanic Membrane Perforation - surgery</subject><subject>tympanoplasty</subject><subject>Tympanoplasty - methods</subject><subject>Young Adult</subject><issn>0023-852X</issn><issn>1531-4995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMtKxDAUhoMoOl42PoAU3IhQzaWZJsthvMKgeENdhTRNMZpOatKifXtTR2fhwtVZnO__OOcHYBfBIwQhPrbS90eYUM5XwAhRgtKMc7oKRnFJUkbx0wbYDOEVQpQTCtfBRoQjlsMReJkYn4RGKp14XXaqNW6etH3dyLmrZWidKbVqXd3HdSOND0lpqsqozrZJo33lvBwiIamdHxTWyML2Sfsil5rGRk-_DdYqaYPe-Zlb4OHs9H56kc6uzy-nk1mqMsx4muOKUYIZKhQvKqRKWowrnJWsICrPGM8YQgWmuYKMDs_DAmVcQqoQH2OpGNkCBwtv4917p0MrahOUtlbOteuCiP1AgiHHOKL7f9BX1_l5vC5SOPoxy3ikDheU8i4EryvReFPHygWCYjhBDP2L7_4jvPej7Ipal0v0t_AIoAXwYazu_1GJ2eT2-VeaLjImtPpzmZH-TYxzklPxeHUubu7uTzAdTwUlX257oHo</recordid><startdate>201406</startdate><enddate>201406</enddate><creator>Redleaf, Miriam I.</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201406</creationdate><title>Air space reduction tympanomastoidectomy repairs difficult perforations more reliably than tympanoplasty</title><author>Redleaf, Miriam I.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4289-72f853281bc9bf1cd5b6f24d8b3c74894811b257c08510020b149a05c1962ac83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Audiometry, Pure-Tone</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Humans</topic><topic>Mastoid - surgery</topic><topic>mastoidectomy</topic><topic>Middle Aged</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Treatment Outcome</topic><topic>Tympanic Membrane - surgery</topic><topic>tympanic membrane perforation</topic><topic>Tympanic Membrane Perforation - surgery</topic><topic>tympanoplasty</topic><topic>Tympanoplasty - methods</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Redleaf, Miriam I.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>The Laryngoscope</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Redleaf, Miriam I.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Air space reduction tympanomastoidectomy repairs difficult perforations more reliably than tympanoplasty</atitle><jtitle>The Laryngoscope</jtitle><addtitle>The Laryngoscope</addtitle><date>2014-06</date><risdate>2014</risdate><volume>124</volume><issue>S3</issue><spage>S1</spage><epage>S13</epage><pages>S1-S13</pages><issn>0023-852X</issn><eissn>1531-4995</eissn><abstract>Objectives/Hypothesis
Air space reduction tympanomastoidectomy improves outcomes over tympanoplasty in repairing tympanic membrane perforations in the presence of unfavorable risk factors.
Study Design
Retrospective review of 67 subjects' 87 operations.
Methods
Interventions were tympanoplasty versus air space reduction tympanomastoidectomy. Risk factors were contracted mastoid air cells, previous failed operations, descent from the indigenous peoples of the Americas, and middle/ear mastoid volumes l<3 CC. Favorable outcomes were closure of the perforation, no decline in hearing, and creation of a self‐cleaning mastoid bowl.
Results
Five out of 46 air space reduction tympanomastoidectomies failed to close their perforations (11%). Pure‐tone threshold (PTA) worsened in 13/46 ears (28%). Four of 46 required mastoid bowl cleaning (9%). In contrast, 21 of 41 tympanoplasties failed to close (51%). PTA worsened in 9/34 ears (26%). All four tympanoplasty failures treated with an air space reduction tympanomastoidectomy closed. Three of the seven tympanoplasty failures treated with a second tympanoplasty did not close. Statistical analysis found two risk factors more prevalent among the air space reduction tympanomastoidectomies: contracted mastoids (P = .019) and middle ear volumes <3 CC (P = .0001). Increased closure of perforations occurring after the air space reduction tympanomastoidectomy was also statistically significant (P = .0002). Descendants of indigenous peoples of the Americas trended toward better PTAs after their air space reduction tympanomastoidectomies than their tympanoplasties and showed statistically significant increases in closure of perforation (P = .0046).
Conclusions
Air space reduction tympanomastoidectomy is an effective and safe method for closing tympanic membrane perforations. © 147.
Level of Evidence
Level of Evidence: 2b Laryngoscope, 124:S1–S13, 2014</abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>23553170</pmid><doi>10.1002/lary.23599</doi><tpages>13</tpages></addata></record> |
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| language | eng |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adolescent Adult Aged Aged, 80 and over Audiometry, Pure-Tone Child Child, Preschool Humans Mastoid - surgery mastoidectomy Middle Aged Retrospective Studies Risk Factors Treatment Outcome Tympanic Membrane - surgery tympanic membrane perforation Tympanic Membrane Perforation - surgery tympanoplasty Tympanoplasty - methods Young Adult |
| title | Air space reduction tympanomastoidectomy repairs difficult perforations more reliably than tympanoplasty |
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