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Myringostapediopexy and myringolenticulopexy in mastoid surgery

Published online by Cambridge University Press:  17 March 2008

P P Cheang ,
D Kim  and
T J Rockley
P P Cheang*
Affiliation:
Department of Otolaryngology, Worcestershire Royal Infirmary, Worcester, UK
D Kim
Affiliation:
Department of Otolaryngology, University Hospital Birmingham, UK
T J Rockley
Affiliation:
Department of Otolaryngology, Queens Hospital, Burton-on-Trent, UK
*
Address for correspondence: Miss Pei Pei Cheang, 10 Canterbury Close, Birmingham B23 7QL, UK. E-mail: ppcheang@gmail.com
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Abstract

Objective:

To compare hearing results in patients undergoing myringostapediopexy or myringolenticulopexy in canal wall down mastoidectomy.

Study design:

Case series of one surgeon. A retrospective review of 83 consecutive mastoid cavity operations for primary cholesteatoma. Only those patients who had undergone either myringostapediopexy or myringolenticulopexy were included.

Setting:

District general hospital.

Patients:

Forty-two procedures were performed in 40 patients. The mean age was 42 years old. The average follow up was 5.9 years.

Intervention:

Seventeen patients underwent myringolenticulopexy (the incus head was excised, leaving the lenticular process attached to the stapes prior to graft placement) and 25 underwent myringostapediopexy (type III tympanoplasty).

Main outcome measures:

Audiometry three to six months after surgery, and status of mastoid cavity after a minimum follow up of one year.

Results:

Comparison of post-operative hearing results for the two groups showed a statistically significant hearing advantage for myringolenticulopexy (p = 0.029). In the myringolenticulopexy group, 92 per cent achieved a post-operative air–bone gap of less than 30 dB, compared with 62 per cent in the myringostapediopexy group. The mean post-operative air–bone gaps in the two groups were 17.5 and 24.7 dB, respectively.

Conclusion:

When surgically feasible, the technique of myringolenticulopexy is a useful method of preserving serviceable hearing in single-stage mastoid cavity surgery.

Keywords

CholesteatomaMastoidectomyTympanoplastyIncusHearing

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 10 , October 2008 , pp. 1042 - 1046
Copyright
Copyright © JLO (1984) Limited 2008

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References

1 Tos, M, Lau, T. Hearing after surgery for cholesteatoma using various techniques. Auris Nasus Larynx 1989;16:61–73CrossRefGoogle ScholarPubMed
2 Tos, M, Lau, T. Late results of surgery in different cholesteatoma types. ORL J Otorhinolaryngol Relat Spec 1989;51:33–49CrossRefGoogle ScholarPubMed
3 Kim, HH, Battista, RA, Kumar, A, Wiet, RJ. Should ossicular reconstruction be staged following tympanomastoidectomy? Laryngoscope 2006;116:47–53CrossRefGoogle ScholarPubMed
4 Kinney, SE. Intact canal wall tympanoplasty with mastoidectomy for cholesteatoma: long-term follow up. Laryngoscope 1998;98:1190–4CrossRefGoogle Scholar
5 Mukherjee, P, Saunders, N, Liu, R, Fagan, P. Long-term outcome of modified radical mastoidectomy. J Laryngol Otol 2004;118:612–16CrossRefGoogle ScholarPubMed
6 Lee, K, Schuknecht, HF. Results of tympanoplasty and mastoidectomy at the Massachusetts Eye and Ear Infirmary. Laryngoscope 1971;81:529–43CrossRefGoogle ScholarPubMed
7 Artuso, A, Di Nardo, W, DeCorso, E, Marchese, MR, Quaranta, N. Canal wall down tympanoplasty surgery with or without ossiculoplasty in cholesteatoma: hearing results. Acta Otorhinolaryngol Ital 2004;24:2–7Google ScholarPubMed
8 Ho, SY, Kveton, JF. Efficacy of the 2-staged procedure in the management of cholesteatoma. Arch Otolaryngol Head Neck Surg 2003;129:541–5CrossRefGoogle ScholarPubMed
9 Quaranta, N, Feijoo, SFV, Piazza, F, Zini, C. Closed tympanoplasty in cholesteatoma surgery: long-term (10 years) hearing results using cartilage ossiculoplasty. Eur Arch Otorhinolaryngol 2001;258:20–4CrossRefGoogle ScholarPubMed
10 Mehta, RP, Ravicz, ME, Rosowski, JJ, Merchant, SN. Middle-ear mechanics of type III tympanoplasty (stapes columella): I. Experimental studies. Otol Neurotol 2003;24:176–85CrossRefGoogle ScholarPubMed
11 Moustafa, H, Khalifa, M. Tympano-cartilago-stapediopexy: a method to improve hearing in open technique tympanoplasty. J Laryngol Otol 1990;104:942–4CrossRefGoogle ScholarPubMed
12 Merchant, SN, McKenna, MJ, Rosowski, JJ. Current status and future challenges of tympanoplasty. Eur Arch Otorhinolaryngol 1998;255:221–8CrossRefGoogle ScholarPubMed
13 Tos, M. Manual of Middle Ear Surgery. New York: Thieme Medical Publishers, 1995:2Google Scholar
14 Meyer, AGW, Albers, FWJ, De Visscher, AVM, Tenvergeri, EM. Validation of hearing results in tympanoplasty: a preliminary report. Acta Otorhinolaryngol Belg 1998;52:313–16Google ScholarPubMed
15 Black, B. Reporting results in ossiculoplasty. Otol Neurotol 2003;24:534–42CrossRefGoogle ScholarPubMed
16 Pennington, CL. Fascia graft myringstapediopexy. Laryngoscope 1966;76:1459–76CrossRefGoogle Scholar
17 Lin, VYW, Campisi, P, Friedberg, J. Why do some children have good hearing results following type III and IV tympanoplasty? Current theories of middle ear mechanics. J Laryngol Otol 2006;35:222–6Google ScholarPubMed
18 Merchant, SN, McKenna, MJ, Mehta, RP, Ravicz, ME, Rosowski, JJ. Middle ear mechanics of type III tympanoplasty (stapes columella): II. Clinical studies. Otol Neurotol 2003;24:186–94CrossRefGoogle ScholarPubMed
19 Alberti, PWR. The blood supply of the incudostapedial joint and the lenticular process. Laryngoscope 1963;73:605–28CrossRefGoogle ScholarPubMed