ABSTRACT
OBJECTIVE To evaluate the impact of mastoid obliteration withsingle-pedicle muscle flap covered by bone pate on vestibular stimulation. METHODS A retrospective study was performed on 59 patients who were treated for chronic otitis media with or without cholesteatoma by two techniques: canal wall down tympano-mastoidectomy(CWD) and subsequent mastoid obliteration(MO). The postoperative vestibular functions of all the patients in both groups were assessed by vestibular function tests and questionnaires. Finally, the data of examination a nd symptoms were a nalyzed. RESULTS After a minimum follow up period of 12 months, the rate of ear dry was 84％(22/26) for MO group and 55％(18/33) for CWD group(χ2=4.72, P <0.05). The dry ear time were 5.46±1.39 weeks for MO group and 8.67±2.3 weeks for CWD group(t =6.2529, P <0.05). When compared latent period of Caloric testing in the MO group (10.3±2.57)s and CWD group (12.7±3.33)s, significant differencewas found(t =3.1639, P <0.05). The postoperative caloric vestibular tests revealed an average nystagmus count of 52.96±20.82 beats per minute in the MO group and 69.94±18.98 beats in the CWD group(t =3.2688, P <0.05). By analyzing the questionnaire, 30％(10/33) of the patients who received CWD treatment reported vertigo by caloric stimuli such as wind, water compared with MO group(0)(χ2=7.45, P <0.05). The rate of suction cleaning induced vertigo was 48％(16/33) in CWD group and 23％(6/26) in MO group(χ2=3.17, P =0.075). CONCLUSION Our technique of mastoid obliteration with single-pedicle muscle flap covered by bone pate results in small cavities with complete epithelialization of all surfaces. Furthermore, obliteration of mastoid cavities provides protection to the labyrinthine organ and reduces postoperative vertigo to caloric stimulation.
ABSTRACT
OBJECTIVE@#To evaluate the effects of intact canal wall tympanoplasty with mastoidectomy (ICWT) with titanium ossicular prostheses.@*METHOD@#A retrospective review was performed on 31 patients who underwent ICWT from 2008 to 2011. Patients' postoperative hearing results and complication rates were evaluated based on different types of ossicular prosthesis: partial ossicular replacement prosthesis (PORP), total ossicular replacement prosthesis (TORP).@*RESULT@#The total effectiveness was 87.1%. No prosthesis was extruded. There was no significant difference in postoperative hearing results (average postoperative gain and ABG) between the two prostheses. In the low frequency (0.5 kHz), significant difference in ABG was found.@*CONCLUSION@#No significant difference in postoperative hearing results was found between PORP and TORP, which could be useful materials for tympanoplasty and obviously improve the hearing of otitis media patients after operation. As for the low incidence of postoperative complications in our short-term study, long-term follow-up visit is necessary.