Randomized clinical trial to evaluate the outcome of partial canal wall preserved tympanomastoidectomy

Abstract

Background: The main surgical techniques for the treatment of chronic otitis media so far, all have their characteristic advantages and disadvantages. Otolaryngologists have been trying to find an ideal surgical method for chronic otitis media.

Objective: To study and evaluate the outcome of partial canal wall preserved tympanomastoidectomy (PCM) for the treatment of chronic otitis media.

Methods: Thirty-nine patients were randomly divided into two groups. Twenty patients underwent PCM and 19 underwent canal wall down tympanomastoidectomy (CWD). All patients had a follow-up period of 5 years.

Results: The mean time of healing was 6 weeks in the PCM group and 8 weeks in the CWD group. The cavities in the PCM group were normal or slightly larger than the normal external auditory canal. The patients required cavity cleaning less than once per year in the PCM group and 3–4 times per year in the CWD group. One patient in the PCM group developed a recurrent cholesteatoma located in the attic.

Conclusion: The PCM technique showed a low-recurrence rate and good hearing outcomes. Patients had normal or slightly enlarged postoperative external auditory canal. Therefore, PCM is a useful technique for chronic otitis media.

Chinese abstract

背景：目前治疗慢性中耳炎的主要外科技术, 都有其独特的优缺点。耳鼻喉科医生一直在寻找一种理想的治疗慢性中耳炎的手术方法。

目的：探讨和评价治疗慢性中耳炎的部分耳道壁保留鼓膜乳突切除术（PCM）的疗效。

方法：将39例患者随机分为两组。20名患者接受了PCM, 19名患者接受了耳道壁下鼓膜乳突切除术（CWD）。所有患者的随访期均为5年。

结果：PCM组平均愈合时间为6周；CWD组平均愈合时间为8周。PCM组耳穴正常或略大于正常外耳道。PCM组患者的耳穴每年至少需要清洁, 而CWD组患者每年需要清洁3-4次。PCM组的一名患者在顶部发生复发性胆脂瘤。

结论：PCM技术导致复发率低及良好的听力。术后外耳道正常或轻度扩大。因此, PCM是治疗慢性中耳炎的有效方法。

Keywords:

• Chronic otitis media
• cholesteatoma
• tympanomastoidectomy
• reconstruction
• obliteration

Disclosure statement

No potential conflict of interest was reported by the authors.

Acknowledgments

The authors acknowledge the help of the patients' randomization by the Institute of Reproductive and Child Health, Ministry of Health Key Laboratory of Reproductive Health, Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China with the assistance of Professor Jianmeng Liu and Yubo Zhou.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported in part by the National Natural Science Foundation of China [Grant no. 81500783 for Y.X. and 39700155 for W.S.).