[Clinical significance of intact canal wall mastoidectomy combined with facial recess opening in the treatment of secretory otitis media of children].

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi

Department of Otorhinolaryngology Head and Neck Surgery, Second Affiliated Hospital, SUN Yat-sen University, Guangzhou 510120, China.

Published: September 2010

AI Article Synopsis

  • The study examines the effectiveness of intact canal wall mastoidectomy combined with facial recess opening in treating children with persistent secretory otitis media who did not benefit from multiple tube insertions.
  • Clinical data from 17 children revealed that pathological examinations showed cholesterol granulomas and inflammatory granulations, but all 19 ears recovered with normal tympanic membranes post-surgery.
  • The results indicate that this surgical approach can effectively clear lesions and ensure long-term ventilation in children with recurrent otitis media, with no recurrences observed in 2 to 3 years of follow-up.

Article Abstract

Objective: To investigate the clinical significance of intact canal wall mastoidectomy combined with facial recess opening in the treatment of secretory otitis media of children.

Methods: The clinical data of 17 children (19 ears) with recurrent secretory otitis media yet failed tube insertion more than 3 times, and treated with intact canal wall mastoidectomy combined with facial recess opening, in the Department of Otorhinolaryngology Head and Neck Surgery, Second Affiliated Hospital of SUN Yat-sen University, were reviewed. And because of the eustachian tube dysfunction, 7 ears simultaneously accepted tube insertion, which were removed after 1 to 3 months.

Results: Pathological examination of the lesions in middle ear and mastoid of the 19 ears, revealed cholesterol granuloma in 9 ears and inflammatory granulation in 10 ears. All 19 ears recovered with normal tympanic membranes. There were 16 ears with type A tympanogram and 3 ears with type C tympanogram (negative pressure less than 150 mm H₂O). The air-bone gaps were less than 15 dB in 3 months after surgery. There was no recurrence in all cases after 2 - 3 years follow-up.

Conclusions: In case of recurrent otitis media in children, especially when tube insertion is ineffective, intact canal wall mastoidectomy combined with facial recess opening can be adopted to clear the lesions thoroughly, and to establish long-time and effective ventilation of eustachian tube, tympanic cavity, tympanic antrum, and mastoid.

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