Revision Surgery for Chronic Otitis Media: Characteristics and Outcomes

Hong, Sang Duk; Cho, Yang Sun; Lee, Hyun Seok; Hong, Sung Hwa; Chung, Won Ho; Bok, Kwon Hyo; Park, Shin Hong

Abstract

BACKGROUND AND OBJECTIVES: The aim of our study is to analyze the characteristics and outcomes of revision surgery for chronic otitis media.
SUBJECTS AND METHOD
Retrospective review of the revision tympanomastoidectomy from January 1, 1997 to December 31, 2004 (N=208) were performed. The control group who underwent primary canal wall down mastoidectomy (CWDM, N=51) was compared with the case group who underwent revision CWDM.
RESULTS
As a cause of revision ear surgery, recurrent cholesteatoma comprised 38% of the cases, and granulation tissue in the unexenterated air cells were found to be 62%. Mastoid tip and perisinal air cells were most frequent sites of unexenterated air cells. CWDM was performed in 96.6% of the patients. Disease control was achieved in 88.5% of the patients. The 70.1% of revision CWDM with ossiculoplasty achieved a residual air-bone gap (ABG) of < or = 30 dB. Complications after revision surgery were wound infection (3.8%) and temporary facial nerve palsy (1.9%). In the control group, disease control rate, postoperative ABG < or = 30 dB, wound infection and facial nerve palsy were 90.2%, 90.5%, 5.9% and 0% of patients, respectively.
CONCLUSION
Disease control rates and complications after revision surgery are similar to primary cases. However, hearing results were worse and wound healing time was longer than primary ones.