Journal of Otology最新文献

{"title":"Nasopharyngeal colonization of otopathogens in South Indian children with acute otitis media – A case control pilot study","authors":"M. Napolean ,&nbsp;V. Rosemol ,&nbsp;M. John ,&nbsp;A.M. Varghese ,&nbsp;J. Periyasamy ,&nbsp;V. Balaji ,&nbsp;P. Naina","doi":"10.1016/j.joto.2021.02.004","DOIUrl":"10.1016/j.joto.2021.02.004","url":null,"abstract":"<div><h3>Background</h3><p>Acute otitis media (AOM) is an inflammatory disease of the middle ear causing significant morbidity in early childhood. A pilot study was undertaken to identify the role of various risk factors South Indian children with AOM, especially the role of nasopharyngeal otopathogens.</p></div><div><h3>Methodology</h3><p>A prospective case control pilot study was conducted in children aged below six years, presenting to a single tertiary care from 2018 to 2019. Fifty cases with AOM and 45 age and gender matched controls were recruited. Two nasopharyngeal swabs were collected, one was processed for bacterial culture. The other swab was processed according to the CDC recommended broth enrichment method to identify carriage of <em>S. pneumoniae.</em> Subsequent serotyping was done by Quellung method and conventional sequential multiplex PCR.</p></div><div><h3>Result</h3><p>Otalgia was the major presentation seen in 92% of the children with AOM. None of the clinical and demographic characteristics were found to be statistically significant between the cases and controls. The most common otopathogen was <em>S. pneumoniae</em> (55%) followed by <em>H. influenza</em> (29%). The common <em>S. pneumoniae</em> serotypes encountered were 11A and 19F.Nasopharyngeal colonization with <em>S. pneumoniae</em> [OR 6.57, p &lt; 0.003] and <em>H. influenzae</em> [OR14.18, p &lt; 0.003] were significant risk factors for AOM in children. The risk increased with co-colonization (OR 13.89,p &lt; 0.003).</p></div><div><h3>Conclusion</h3><p>This study strengthens the significant association between nasopharyngeal colonization of otopathogens and AOM as a risk factor that is enhanced by co-colonization.<em>S. pneumoniae</em> was the main otopathogen in this population, serotypes 11A and 19F being the most common.</p></div>","PeriodicalId":37466,"journal":{"name":"Journal of Otology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.joto.2021.02.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39437299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of cerebral digital subtraction angiography in the evaluation of pulse synchronous tinnitus","authors":"Gregory P. Lekovic ,&nbsp;Zachary R. Barnard ,&nbsp;Adam Master ,&nbsp;Gautam U. Mehta ,&nbsp;M. Marcel Maya ,&nbsp;Eric P. Wilkinson","doi":"10.1016/j.joto.2021.03.002","DOIUrl":"10.1016/j.joto.2021.03.002","url":null,"abstract":"<div><h3>Objectives</h3><p>The aim of this study was to evaluate the value of digital subtraction angiography (DSA) in the diagnostic evaluation of a highly selected patient population presenting with pulse-synchronous tinnitus (PST).</p></div><div><h3>Methods</h3><p>We retrospectively reviewed the charts of all patients referred for evaluation of possible vascular etiology of pulsatile tinnitus. Patients were evaluated with regards to presenting signs, comorbidities, non-invasive imaging results, angiographic findings and outcomes.</p></div><div><h3>Results</h3><p>Fifteen patients underwent cerebral DSA. Dural arteriovenous fistula (dAVF) was identified in six patients, and five patients had other significant vascular pathology identified on DSA. Seven patients with ‘negative’ non-invasive imaging were found to have significant pathology on DSA.</p></div><div><h3>Conclusions</h3><p>Catheter angiography may have a significant yield in appropriately selected patients presenting with pulse synchronous tinnitus.</p></div>","PeriodicalId":37466,"journal":{"name":"Journal of Otology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.joto.2021.03.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39437300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"It's all about timing, early treatment with hyperbaric oxygen therapy and corticosteroids is essential in acute acoustic trauma","authors":"A.B. Bayoumy ,&nbsp;R.P. Weenink ,&nbsp;E.L. van der Veen ,&nbsp;F.S. Besseling-Hansen ,&nbsp;A.D.M. Hoedemaeker ,&nbsp;F.J.M. de Jong ,&nbsp;M.H. van der Laan ,&nbsp;R. Swenker ,&nbsp;R.A. van Hulst ,&nbsp;J.A. de Ru","doi":"10.1016/j.joto.2021.05.001","DOIUrl":"10.1016/j.joto.2021.05.001","url":null,"abstract":"<div><h3>Background</h3><p>Acute acoustic trauma (AAT) is an acute hearing impairment caused by intense noise-impact. The current management strategy for AAT with substantial hearing loss in the Dutch military is the combination therapy with corticosteroids and hyperbaric oxygen therapy (HBOT). In a previous study, early initiation of the combination therapy was associated with better outcomes. Therefore, we performed a new analysis to assess the difference in hearing outcome between patients in whom combination therapy was started within two days, versus after more than two days.</p></div><div><h3>Methods</h3><p>A retrospective analysis was performed on military patients diagnosed with AAT with substantial hearing loss who presented between February 2018 and March 2020. Absolute and relative hearing improvement between first and last audiograms were calculated for all affected frequencies (defined as loss of ≥20 dB on initial audiogram). We also determined the amount of patients who recovered to the level of Dutch military requirement, and performed speech discrimination tests.</p></div><div><h3>Results</h3><p>In this analysis, 30 male patients (49 ears) with AAT were included. The median age was 24.5 years (IQR 23–29). The median time to initiation of therapy with corticosteroids and HBOT were one and two days, respectively. HBOT was started within two days in 31 ears, and after more than two days in 18 ears. The mean absolute and relative hearing gains were 18.8 dB (SD 14.6) and 46.8% (SD 31.3) on all affected frequencies. The 100% discrimination/speech perception level improved from 64.0 dB to 51.7 dB (gain 12.3 dB ± 14.1). There was significantly more improvement in absolute and relative hearing improvement when HBOT was started in ≤2 days, compared to &gt;2 days.</p></div><div><h3>Conclusion</h3><p>Our analysis shows results in favor of early initiation (≤2 days) of the combination treatment of HBOT and corticosteroids in patients with AAT.</p></div>","PeriodicalId":37466,"journal":{"name":"Journal of Otology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.joto.2021.05.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39439583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparative study of two methods for treatment of benign paroxysmal positional vertigo in the emergency department","authors":"D. Giardino ,&nbsp;M. Musazzi ,&nbsp;M. Perez Akly ,&nbsp;M. Cherchi ,&nbsp;D.A. Yacovino","doi":"10.1016/j.joto.2021.04.002","DOIUrl":"10.1016/j.joto.2021.04.002","url":null,"abstract":"<div><h3>Introduction</h3><p>Posterior canal benign paroxysmal positional vertigo (PC-BPPV) is considered the most common cause of peripheral vertigo in the emergency department (ED). Although the canalith repositioning maneuver (CRM) is the standard of care, the most effective method to deliver it in the ED has been poorly studied.</p></div><div><h3>Objective</h3><p>To compare two protocols of the Epley maneuver for the treatment of PC-BPPV.</p></div><div><h3>Patients and methods</h3><p>We prospectively recruited 101 patients with unilateral PC-BPPV on physical examination, randomizing them to either a single Epley maneuver (EM) (n = 46) or multiple maneuvers (n = 55) on the same visit. Measured outcomes included presence/absence of positional nystagmus, resolution of vertigo, and score on the dizziness handicap inventory (DHI) at follow-up evaluations. The DHI was stratified into mild (≤30) and moderate-severe (&gt;30).</p></div><div><h3>Results</h3><p>Normalization of the Dix-Hallpike maneuver at day 5 was observed in 38% of the single EM group and 44.4% in the multiple EM group (p = 0.62). The DHI showed reduction from 42.2 (SD 18.4) to 31.9 (SD 23.7) in the single EM group and from 43.7 (SD 22.9) to 33.5 (SD 21.5) in the multiple EM group (p = 0.06). A higher number of patients improved from moderate-severe to mild DHI (p = 0.03) in the single EM group compared to the multi-EM group (p = 0.23).</p></div><div><h3>Conclusion</h3><p>There was no statistically significant difference between performing a single EM versus multiple EMs for treatment of PC-BPPV in the emergency department. The single EM approach is associated with shorter physical contact between patients and examiner, which is logically safer in a pandemic context.</p></div>","PeriodicalId":37466,"journal":{"name":"Journal of Otology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.joto.2021.04.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39439582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subjective tinnitus: lesion-induced pathological central homeostasis remodeling","authors":"Qi Zhang,&nbsp;Lidong Zhao,&nbsp;Weidong Shen,&nbsp;Shiming Yang","doi":"10.1016/j.joto.2021.04.001","DOIUrl":"10.1016/j.joto.2021.04.001","url":null,"abstract":"<div><p>Subjective tinnitus is the most common type of tinnitus, which is the manifestation of pathological activities in the brain. It happens in a substantial portion of the general population and brings significant burden to the society. Severe subjective tinnitus can lead to depression and insomnia and severely affects patients’ quality of life. However, due to poor understanding of its etiology and pathogenesis, treatment of subjective tinnitus remains challenging. In recent decades, a growing number of studies have shown that subjective tinnitus is related to lesion-induced neural plasticity of auditory and non-auditory central systems. This article reviews cellular mechanisms of neural plasticity in subjective tinnitus to provide further understanding of its pathogenesis.</p></div>","PeriodicalId":37466,"journal":{"name":"Journal of Otology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.joto.2021.04.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39439587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contralateral delayed endolymphatic hydrops: Clinical features and long term outcome","authors":"Andrea Albera ,&nbsp;Andrea Canale ,&nbsp;Marco Boldreghini ,&nbsp;Sergio Lucisano ,&nbsp;Giuseppe Riva ,&nbsp;Roberto Albera","doi":"10.1016/j.joto.2021.02.003","DOIUrl":"10.1016/j.joto.2021.02.003","url":null,"abstract":"<div><h3>Background</h3><p>Contralateral delayed endolymphatic hydrops (CDEH) is a clinical entity characterized by fluctuating low frequency hearing loss and/or vertigo, mimicking Ménière’s disease (MD), that manifests after the appearance of severe non-hydropic hearing loss (NHHL) at the other ear.</p></div><div><h3>Objectives</h3><p>to describe the clinical features and the course of 57 patients affected by CDEH.</p></div><div><h3>Method</h3><p>this is a retrospective study; 57 patients affected by CDEH, out of 1065 patients seen in the same period and affected by MD, were subjected to otoscopy, PTA threshold evaluation, impedance testing, ABR, research of positioning nystagmus, vestibular function evaluated by means of bithermal caloric test under video-oculographic, and MRI with gadolinium.</p></div><div><h3>Results</h3><p>the CDEH was definite in 24 cases (42%), probable in 2 (4%) and possible in 31 (54%). The mean PTA threshold at the hydropic ear was 41 dB. At the last follow-up, 40 patients (70%) did not report vertigo or fluctuating hearing loss. Among the 17 patients who still reported symptomatology, 11 (64%) were affected by fluctuating hearing loss alone, 4 (23%) reported a subjective worsening of hearing loss and 2 (12%) an acute vertigo crisis.</p></div><div><h3>Conclusions</h3><p>contralateral delayed endolymphatic hydrops is a relatively rare form of Ménière disease that manifests more frequently as a definite form or with fluctuating low-frequency hearing loss. The prognosis at a long term follow-up is relatively good in terms of vertigo resolution. Contralateral delayed endolymphatic hydrops rarely determines a severe hearing loss in the better ear.</p></div>","PeriodicalId":37466,"journal":{"name":"Journal of Otology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.joto.2021.02.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39437296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SARS-CoV-2 and hearing: An audiometric analysis of COVID-19 hospitalized patients","authors":"Francisco Alves de Sousa ,&nbsp;Rodrigo Pinto Costa ,&nbsp;Sandra Xará ,&nbsp;Ana Nóbrega Pinto ,&nbsp;Cecília Almeida e Sousa","doi":"10.1016/j.joto.2021.01.005","DOIUrl":"10.1016/j.joto.2021.01.005","url":null,"abstract":"<div><h3>Purpose</h3><p>COVID-19 associated hearing loss is still an ongoing matter of debate. No original studies exist on audiological effects of SARS-CoV-2 infection in hospitalized patients. The main objective was to determine whether SARS-CoV-2 may affect auditory function in clinically ill COVID-19 patients.</p></div><div><h3>Materials and methods</h3><p>COVID-19 patients with moderate-severe disease and without prior history of hearing abnormalities were enrolled from a tertiary referral center, and matched with controls. Participants performed an audiometric evaluation, and thresholds were compared.</p></div><div><h3>Results</h3><p>120 ears from 60 patients were enrolled. Patients with COVID-19 showed worse mean auditory thresholds starting from 1000 Hz through higher frequencies, when compared to controls (<u>1000 Hz</u>: 18.52 ± 5.49 dB HL in controls vs 25.36 ± 6.79 dB HL in COVID-19, p &lt; 0.001; <u>2000Hz</u>: 17.50 ± 5.57 dB HL in controls vs 21.96 ± 7.05 dB HL in COVID-19, p = 0.010; <u>3000Hz</u>: 17.97 ± 8.07 dB HL in controls vs 25 ± 9.38 dB HL in COVID-19, p = 0.003; <u>4000 Hz</u>: 20.16 ± 10.12 dB HL in controls vs 29.55 ± 11.26 dB HL in COVID-19, p = 0.001; <u>8000 Hz</u>: 31.09 ± 12.75 dB HL in controls vs 40.71 ± 19.40 dB HL in COVID-19, p = 0.030; <em><u>Pure Tone Average</u></em>: 20.42 ± 4.29 dB HL in controls vs 24.85 ± 5.62 dB HL in COVID-19, p = 0.001). Statistical significance persisted after adjusting for confounders such as age, gender and various comorbidities (p &lt; 0.05).</p></div><div><h3>Conclusions</h3><p>SARS-CoV-2 may affect hearing in COVID-19 patients with moderate-severe disease. Results are in line with the previous suggested effects of COVID-19 on auditory system. This study is expected to encourage further research on this topic.</p></div>","PeriodicalId":37466,"journal":{"name":"Journal of Otology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.joto.2021.01.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25349061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intratympanic vs systemic use of steroids as first-line treatment for sudden hearing loss: A meta-analysis of randomized, controlled trials","authors":"Ting Yang ,&nbsp;Hui Liu ,&nbsp;Fangyao Chen ,&nbsp;An Li ,&nbsp;Zhou Wang ,&nbsp;Shuangyuan Yang ,&nbsp;Shiyu Yang ,&nbsp;Wen Zhang","doi":"10.1016/j.joto.2021.02.001","DOIUrl":"10.1016/j.joto.2021.02.001","url":null,"abstract":"<div><h3>Background</h3><p>Sudden sensorineural hearing loss (SSNHL) is a common disease in otology, and steroids play an important role in its treatment. Steroids can be administered systemically or locally, and the efficacies of different administration routes remain controversial.</p></div><div><h3>Methods</h3><p>We searched the Cochrane, EMBASE, PubMed, Web of Science, CNKI, Wanfang and Weipu databases for randomized controlled trials (RCTs) on glucocorticoid treatments for SSNHL to compare the efficacy of topical and systemic steroid administration. The Review Manager 5.4 software was used for synthesis of data: the rate of reported hearing improvement and change in pure-tone audiometry (PTA).</p></div><div><h3>Results</h3><p>In all the included studies, when intratympanic administration was compared to systemic therapies, the risk difference (RD) using reported hearing improvement as an outcome measure was 0.08 (95% CI: 0.01–0.14, I² = 45%). Using PTA changes as an outcome measure in 4 studies, the mean difference (MD) was 10.43 dB (95% CI: 3.68–17.18, I² = 81%). Hearing improvement RD was also compared among different types of steroid, recovery criteria, follow-up times and diagnostic criteria, and showed no significant differences exception for recovery criteria (&gt;10 dB) (RD -0.06, 95% CI: 0.14-0.2, I² = 0%).</p></div><div><h3>Conclusion</h3><p>As the initial treatment for SSNHL, topical steroids seem to be superior to systemic steroid administration, especially in patients with contraindications to systemic steroids usage. However, further verification based on high-quality research is needed.</p></div>","PeriodicalId":37466,"journal":{"name":"Journal of Otology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.joto.2021.02.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39148988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of otology specific outcome measure: Ear Outcome Survey-16 (EOS-16)","authors":"Juha T. Laakso ,&nbsp;Juha Silvola ,&nbsp;Timo Hirvonen ,&nbsp;Samuli Suutarla ,&nbsp;Ilkka Kivekäs ,&nbsp;Riitta Saarinen ,&nbsp;Lotta Haavisto ,&nbsp;Jaakko Laitakari ,&nbsp;Antti A. Aarnisalo ,&nbsp;Aarno Dietz ,&nbsp;Jussi Jero ,&nbsp;Maija Hytönen ,&nbsp;Saku T. Sinkkonen","doi":"10.1016/j.joto.2021.01.003","DOIUrl":"10.1016/j.joto.2021.01.003","url":null,"abstract":"<div><h3>Purpose</h3><p>An important outcome measure of patient care is the impact on the patient’s health-related quality of life (HRQoL). Current ear-specific HRQoL instruments are designed for one diagnosis and emphasize different subdivisions such as symptoms, hearing problems, psychosocial impact, and the need for care. The optimal length of the recall period has not been studied. For these reasons, a new survey is needed that would cover most chronic ear diseases.</p></div><div><h3>Methods</h3><p>A preliminary 24-item survey (EOS-24) was created. Untreated adult patients (included n = 186) with one of seven different chronic otologic conditions from all university hospitals in Finland were recruited to respond to EOS-24 and the 15D general HRQoL instrument. The recruiting otologists evaluated the severity of the disease and the disability caused by it. A control group was recruited. Based on the patients’ responses in different diagnosis groups, the items were reduced according to pre-defined criteria. The resulting survey was validated using a thorough statistical analysis.</p></div><div><h3>Results</h3><p>The relevance and necessity of the original 24 items were thoroughly investigated, leading to the exclusion of 8 items and the modification of 1. The remaining 16 items were well-balanced between subdivisions and were useful in all seven diagnosis groups, thus constituting the final instrument, EOS-16. The most suitable recall period was three months.</p></div><div><h3>Conclusions</h3><p>EOS-16 has been created according to the HRQoL survey guidelines with a versatile nationwide patient population. The survey has been validated and can be used for a wide range of chronic ear diseases as a HRQoL instrument.</p></div>","PeriodicalId":37466,"journal":{"name":"Journal of Otology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.joto.2021.01.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39148987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mastoid obliteration and reconstruction techniques: A review of the literature","authors":"Michelle Lupa Mendlovic ,&nbsp;Daniella Alejandra Monroy Llaguno ,&nbsp;Ivan Hermann Schobert Capetillo ,&nbsp;Juan Carlos Cisneros Lesser","doi":"10.1016/j.joto.2021.01.002","DOIUrl":"10.1016/j.joto.2021.01.002","url":null,"abstract":"<div><h3>Objective</h3><p>To review the published literature related to the different obliteration and reconstruction techniques in the management of the canal wall down mastoidectomy.</p></div><div><h3>Methods</h3><p>A PubMed (Medline) and LILACS databases as well as crossed references search was performed with the following Mesh terms: “cholesteatoma”, “cholesteatoma-middle ear”, “otitis media”, “otitis media, suppurative”, “mastoiditis”, “mastoidectomy”, “canal wall down mastoidectomy”, “radical mastoidectomy”, “mastoid obliteration” and crossed references. Inclusion criteria were adult patients subject to mastoid cavity obliteration and posterior canal wall reconstruction. The technique and materials used, anatomic and functional results, complications, recurrence rates, and changes in quality of life, were analyzed. A total of 94 articles were screened, 38 were included for full-text detailed review.</p></div><div><h3>Results</h3><p>Twenty-one articles fulfilled the inclusion criteria. Techniques and materials used for canal wall reconstruction, tympanoplasty, and ossiculoplasty were varied and included autologous, biosynthetic, or both. Auditory results were reported in 16 studies and were inconsistent. Three studies reported improvement in the quality of life using the GBI scale. Follow-up time ranged from 1 to 83 months. Eleven articles used imaging studies to evaluate postoperative disease recurrence. The highest recurrence rate reported for cholesteatoma after obliteration was 19%. The most frequently reported complications were retraction pockets and transient otorrhea.</p></div><div><h3>Conclusion</h3><p>Plenty of techniques combining grafts and other materials have been used to overcome mastoidectomy cavity problems. So far, it is still not possible to standardize an ideal procedure. The available level of evidence for this topic is low and limited.</p></div>","PeriodicalId":37466,"journal":{"name":"Journal of Otology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.joto.2021.01.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39148989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}