Postoperative Mastoid Aeration Following Canal Wall Up Mastoidectomy according to Preoperative Middle Ear Disease: Analysis of Temporal Bone Computed Tomography Scans
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Background and Objectives: The aim of our study was to evaluate postoperative mastoidaeration according to the preoperative middle ear disease and investigate the factors affectingit. Subjects and Methods: We retrospectively reviewed the high-resolution computed tomography(CT) scans of temporal bones that were taken 1 year after surgery. The postoperativemastoid aeration was evaluated according to the preoperative diagnosis, and classifiedinto three groups: grade 1 (complete mastoid aeration), an air-filled epitympanum and mastoidcavity; grade 2 (partial mastoid aeration), an air-filled epitympanum and partially aerated mastoidcavity; and grade 3 (absence of mastoid aeration), no air space in the mastoid cavity. Results:The overall mastoid aeration rate was 55.8%, with adhesive otitis media accounting for21.2%, attic cholesteatoma 53.8%, and chronic otitis media 75.4%. The rates of postoperativemastoid aeration were significantly higher in the chronic otitis media cases and attic cholesteatomacases than in the adhesive otitis media cases. There were 14 cases requiring revisionoperations due to the development of a retraction pocket in the tympanic membrane. Allof the revised cases had grade 3 postoperative mastoid aeration, and underwent canal walldown mastoidectomies. Conclusions: The degree of postoperative mastoid aeration is associatedwith the preoperative middle ear disease. When planning a canal wall up mastoidectomy,the surgeon should contemplate the middle ear disease, because a canal wall downmastoidectomy or mastoid obliteration is recommended if the patient has adhesive otitismedia.
Abstract
Background and Objectives: The aim of our study was to evaluate postoperative mastoidaeration according to the preoperative middle ear disease and investigate the factors affectingit. Subjects and Methods: We retrospectively reviewed the high-resolution computed tomography(CT) scans of temporal bones that were taken 1 year after surgery. The postoperativemastoid aeration was evaluated according to the preoperative diagnosis, and classifiedinto three groups: grade 1 (complete mastoid aeration), an air-filled epitympanum and mastoidcavity; grade 2 (partial mastoid aeration), an air-filled epitympanum and partially aerated mastoidcavity; and grade 3 (absence of mastoid aeration), no air space in the mastoid cavity. Results:The overall mastoid aeration rate was 55.8%, with adhesive otitis media accounting for21.2%, attic cholesteatoma 53.8%, and chronic otitis media 75.4%. The rates of postoperativemastoid aeration were significantly higher in the chronic otitis media cases and attic cholesteatomacases than in the adhesive otitis media cases. There were 14 cases requiring revisionoperations due to the development of a retraction pocket in the tympanic membrane. Allof the revised cases had grade 3 postoperative mastoid aeration, and underwent canal walldown mastoidectomies. Conclusions: The degree of postoperative mastoid aeration is associatedwith the preoperative middle ear disease. When planning a canal wall up mastoidectomy,the surgeon should contemplate the middle ear disease, because a canal wall downmastoidectomy or mastoid obliteration is recommended if the patient has adhesive otitismedia.
참고문헌 (17)
- Brackmann DE, "Tympanoplasty with mastoidectomy: canal wall up procedures", Am J Otol, 14, pp.380~382 (1993)
- Kenna MA, "Treatment of chronic suppurative otitis media", Otolaryngol Clin North Am, 27, pp.457~472 (1994)
- McGrew BM, "Impact of mastoidectomy on simple tympanic membrane perforation repair", Laryngoscope, 114, pp.506~511 (2004)
- Ramakrishnan A, "Cortical mastoidectomy in surgery of tubotympanic disease. Are we overdoing it?", Surgeon, 9, pp.22~26 (2011)
- Eliades SJ, "The role of mastoidectomy in outcomes following tympanic membrane repair: a review", Laryngoscope, 123, pp.1787~1802 (2013)
- Ruhl CM, "Role of aerating mastoidectomy in noncholesteatomatous chronic otitis media", Laryngoscope, 109, pp.1924~1927 (1999)
- Vrabec JT, "Aeration following intact canal wall mastoidectomy", Ann Otol Rhinol Laryngol, 112(9 Pt 1), pp.801~806 (2003)
- Sadé J, "Atelectasis and secretory otitis media", Ann Otol Rhinol Laryngol, 85(2 Suppl 25 Pt 2), pp.66~72 (1976)
- 김창우, "Usefulness of the Attic Reconstruction Using the Tragal Cartilage and Perichondrium for Prevention of a Retraction Pocket", Journal of Audiology & Otology, 15(3), pp.124~128 (2011), 대한청각학회
- Minoda R, "Efficacy of mastoid cortex plasty for middle ear aeration in intact canal wall tympanoplasty for cholesteatoma", Otol Neurotol, 23, pp.425~430 (2002)
- Cinamon U, "Mastoid and tympanic membrane as pressure buffers: a quantitative study in a middle ear cleft model", Otol Neurotol, 24, pp.839~842 (2003)
- Gaihede M, "Middle ear pressure regulation--complementary active actions of the mastoid and the Eustachian tube", Otol Neurotol, 31, pp.603~611 (2010)
- Bluestone CD, "Function of the Eustachian tube related to surgical management of acquired aural cholesteatoma in children", Laryngoscope, 88(7 Pt 1), pp.1155~1164 (1978)
- Tierney PA, "An assessment of the value of the preoperative computed tomography scans prior to otoendoscopic ‘second look’ in intact canal wall mastoid surgery", Clin Otolaryngol Allied Sci, 24, pp.274~276 (1999)
- Palva T, "Surgical treatment of chronic middle ear disease. III. Revisions after tympanomastoid surgery", Acta Otolaryngol, 105, pp.82~89 (1988)
- Takahashi H, "Cause of posterior canal wall retraction after surgery from the viewpoint of mastoid conditions", Am J Otol, 19, pp.131~135 (1998)
- Tono T, "Computed tomographic evaluation of middle ear aeration following intact canal wall tympanoplasty", Auris Nasus Larynx, 14, pp.123~130 (1987)