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Randomized clinical trial for partial canal wall preserved mastoitympanoplasty

Presenting Author: Xin Ying

Published online by Cambridge University Press:  03 June 2016

Xin Ying  and
Song Weiming
Xin Ying
Affiliation:
Peking University
Song Weiming
Affiliation:
Peking University
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Abstract

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Learning Objectives:

Objective: To study and evaluate the outcome of partial canal wall preserved mastoitympanoplasty (PCM) for chronic otitis media with cholesteatoma and/or granulation tissue.

Methods: Thirty-nine patients were randomly divided into two groups. 20 patients underwent PCM, 19 patients underwent canal wall down mastoitympanoplasty(CWD). All of the patients had a follow-up period of 5 years.

Results: All the patients in the two groups underwent the operation successfully and no intraoperative or postoperative complications were found. The mean time of drying of cavity was 6 weeks (4–8weeks) in the PCM group, while it was 8 weeks (6–10weeks) in the CWD group. The cavity in the PCM group were near normal or slightly larger than the external auditory canal, and the tympanal flaccid part slightly wider than normal, patients could able to wear traditional hearing aids. The patients need cavity cleaning less than 1 times a year in the PCM group and 3–4 times a year in the CWD group. The surgery cavity volume was 1.4 + 0.2 ml in the PCM group and 2.6 + 1.1 ml in the CWD group (P < 0.05), the difference was statistically significant. There were 8 patients (40%) improved hearing level (threshold improved > 10 dB) 5 years after operation in the PCM group and 6 patients (32%) in the CWD group, no statistically significant difference. 1 patient (5%) developed a recurrenct cholesteatoma which was located in the attic and 4 patients (20%) developed retraction pockets in the attic in the PCM group, while 3 patients (15.8%) developed cavity problem that the epithelial accumulation were not easy to clean in the CWD group, no statistically significant difference.

Conclusion: With PCM technique, cholesteatoma could be completely and safely removed from the middle ear, and patients had near normal postoperative external auditory canal. Therefore, PCM was a reasonable choice for the surgery of otitis media with cholesteatoma and/or granulation tissue.