A COMPREHENSIVE STUDY ON FACTORS AFFECTING POST-MASTOIDECTOMY RECOVERY
Main Article Content
Keywords
chronic suppurative otitis media, CSOM, Otorrhea, Mastoidectomy
Abstract
Objective: To study the surgical healing outcomes at the end of three month post-operative period. Material and method: This was a hospital based prospective observational study with three months postoperative follow up design. The study was conducted for a total duration of two years and 6 months from July 2019 to January 2022 with 67 study participants. The study was carried out in the hospital setting at the department of ENT in a tertiary care hospital in south India. Individuals from all age groups who were diagnosed with Chronic Suppurative Otitis Media-Attico Antral Disease (CSOM-AAD) with or without extracranial complications are eligible for Mastoidectomy. Results: A significant association was observed between preoperative polyp and post-operative size of the mastoid cavity with epithelization of fascial graft. A significant association was observed between the postoperative Merchant’s grade(otorrhea) and the size of the meatoplasty opening. A very strong association was appreciated between the presence of epithelization in the graft (OR: 0.18; p-value: <0.001) and the smaller size of the mastoid cavity after surgery. A significant association was appreciated between the duration of symptoms and epithelization of the fascial graft (OR: 0.23; p-value: 0.004). Conclusion: It was concluded that the duration of symptoms, size of mastoid cavity, size of meatoplasty opening, and presence of preoperative polyp have significant effects in determining post operative healing in post mastoidectomy patients.
References
2. Verhoeff M, Van Der Veen EL, Rovers MM, Sanders EAM, Schilder AGM. Chronic suppurative otitis media: A review. Int J Pediatr Otorhinolaryngol. 2006 Jan 1;70(1):1–12.
3. Morris P. Chronic suppurative otitis media. BMJ Clin Evid. 2012;2012.
4. Verhoeff M, Van Der Veen EL, Rovers MM, Sanders EAM, Schilder AGM. Chronic suppurative otitis media: A review. Int J Pediatr Otorhinolaryngol. 2006 Jan;70(1):1–12.
5. Rosario DC, Mendez MD. Chronic Suppurative Otitis. StatPearls. 2022 Jan 4;
6. M V, EL van der V, MM R. Chronic suppurative otitis media: a review. Vol. 70. p. 1–12.
7. Brar S, Watters C, Winters R. Tympanoplasty. Indian J Otolaryngol Head Neck Surg. 2021 Dec 29;46(2):63–6.
8. Methwani DA, Deshmukh PT. Comparative study of type I tympanoplasty with or without mastoidectomy in tubotympanic type of chronic suppurative otitis media patients. J Datta Meghe Inst Med Sci Univ. 2017 Apr 1;12(2):85.
9. DR Nayak RBPHPM. Role of cortical mastoidectomy in the results of myringoplasty for dry tubotympanic disease. Indian J Otol. 2003;9:11–5.
10. Kakkar V. Role of cortical mastoidectomy on the results of tympanoplasty in tubotympanic type of CSOM. Natl J Otorhinolaryngol Head Neck Surg. 2014;2(11):3.
11. Yuen APW, Ho WK, Wei WI, Hui Y, Au DKK. Correlation of pure tone audiogram results and hearing benefit of tympanoplasty for chronic suppurative otitis media. Ann Otol Rhinol Laryngol. 2000 Jun 28;109(4):381–4.
12. Kabdwal N, Varshney S, Bist S, Bhagat S, Mishra S, Agarwal V. Pre and post operative evaluation of hearing in chronic suppurative otitis media. Indian J Otol. 2013 Oct;19(4):164.
13. Cook JA, Krishnan S, Fagan PA. Hearing results following modified radical versus canal up mastoidectomy. Ann Otol Rhinol Laryngol. 1996;105(5):379–83.
14. Mahadevaiah A, & BPIJ of O and H, 2008 undefined. Modified intact canal wall mastoidectomy—long term results in hearing and healing. Springer.
15. Pir Bux Magsi BJHAS. Clinical presentation and outcome of mastoidectomy in chronic suppurative otitis media (CSOM) at a tertiary care hospital Sukkur, Pakistan. Rawal Med J. 2012;37(1):50–3.
16. Mishiro Y, Sakagami M, Kondoh K, Kitahara T, Kakutani C. Long term outcomes after tympanoplasty with or without mastoidectomy for perforation in CSOM. Eur Arch Otorhinolaryngol. 2009 Jun;266(6):819–22.
17. Shah AK, Patel S, Pawde A. Surgical Outcome of Mastoid Cavity Obliteration Using Postauricular Composite Bone with Periosteum Flap. Indian J Otolaryngol Head Neck Surg Off Publ Assoc Otolaryngol India. 2019 Mar 4;71(1):115–9.
18. Kim MB, Choi J, Lee JK, Park JY, Chu H, Cho YS, et al. Hearing Outcomes According to the Types of Mastoidectomy: A Comparison between Canal Wall Up and Canal Wall Down Mastoidectomy. Clin Exp Otorhinolaryngol. 2010 Dec;3(4):203.
19. Ikeda M, Yoshida S, Ikui A, Laryngology SSTJ of, 2003 undefined. Canal wall down tympanoplasty with canal reconstruction for middle-ear cholesteatoma: post-operative hearing, cholesteatoma recurrence, and status of re-aeration. cambridge.org.
20. Chhapola S, Neck IMIJ of O and H&, 2014 undefined. Mastoid obliteration versus open cavity: a comparative study. Springer.
21. Li R, Wu N, Zhang J, Hou Z, Yang S. Analysis on the correlation between Eustachian tube function and outcomes of type I tympanoplasty for chronic suppurative otitis media. https://doi.org/101080/0001648920201754462. 2020 Jul 31;140(8):664–7.
22. Sato H, Nakamura H, Honjo I, Hayashi M. Eustachian tube function in tympanoplasty. Acta Otolaryngol (Stockh). 1990;110(S471):9–12.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Vishak Ms
Senior Resident, Department of Otorhinolaryngology JIPMER, Puducherry
Anjali Rajkumar
MBBS, JIPMER, Puducherry
Sivaraman G
Additional Professor & Head of, Department of Otorhinolaryngology JIPMER, Puducherry
Kalaiarasi Raja
Associate Professor, Department of Otorhinolaryngology JIPMER, Puducherry