The Efficacy of Open Mastoidectomy Versus Mastoidectomy with Temporalis Fascia Flap Obliteration
DOI:
https://doi.org/10.17140/PLMOJ-4-111Keywords:
Chronic suppurative otitis media (CSOM), Mastoidectomy, Ear, nose, and throat (ENT)Abstract
Objective
To compare the efficacy of open mastoidectomy versus mastoidectomy with temporalis fascia flap obliteration in achieving postoperative
dry ear chronic suppurative otitis media (CSOM) is a perforated tympanic membrane with persistent drainage of pus
from the middle ear lasting more than 2-weeks. The global burden of illness from CSOM is estimated to involve about 65 to 330
million individuals with draining ears, 60% of them suffer from significant hearing impairment. Ninety (90) percent of burden is
borne by developing countries, in Southeast Asia, the Western region of Africa. CSOM can occur with or without cholesteatoma,
and the clinical history of both conditions can be very similar. The treatment plan for cholesteatoma always includes tympanomastoid
surgery with medical treatment as an adjunct. The treatment plan for cholesteatoma always includes tympanomastoid surgery.
After mastoidectomy the otologists facing mastoid cavity related problems such as otorrhoea, hearing loss. A variety of techniques
have been proposed to perform obliteration.
Methods
Study design
Randomized Controlled Trial.
Setting
Department of ear, nose, and throat (ENT), Head & Neck Surgery, Saidu Group of Teaching Hospital, Swat, Khyber Pakhtunkhwa,
Pakistan.
Duration of study
From Jan, 2019 to 17 July, 2021.
Sample size
Randomly assigned patients with evidence of atticoantral disease to two groups, 47 in each group. After canal wall down mastoidectomy
in Group A cavity left without obliteration, in Group B a superior based vascularized temporalis facial flap was used to
obliterate the resultant mastoid cavity and they were followed up to 8-weeks.
Results
As per efficacy of both groups is concerned, in Group A, 34 (36.17%) patients had achieved post-operative dryness on 8th week
of mastoidectomy whereas in Group B, 40 (42.55%) patients achieved post-operative dryness of ear on 8th week subject to mastoidectomy
with temporalis fascia flap obliteration. (p value=0.130).
Conclusion
Patients who underwent mastoidectomy with temporalis fascia flap obliteration yielded better results in comparison to patients
who underwent open mastoidectomy. Further the common organism were found in our region Staph Aureus and Bacteriodes and
Proteus mirabilis.
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