Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “MASTOID SURGERY”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources
PubMed2004

Paediatric small cavity mastoid surgery: second look tympanotomy.

OBJECTIVE: Following surgery for retraction pocket/cholesteatoma there is risk of residual disease, after canal wall up surgery a second look tympanotomy is routinely recommended. After canal wall down (CWDM) surgery this is not routine. In certain situations the senior author recommends second look tympanotomy. This report examines the outcome of this management paradigm applied to small cavity mastoid surgery for children. METHOD: A retrospective review of small cavity mastoid surgery for children with cholesteatoma or discharging retraction pocket disease. The primary procedure and surgical findings at second look tympanotomy are reported as well as the pre- and 1 year post-operative air and bone conduction thresholds and air-bone gap averaged across frequencies 0.5, 1, 2 and 4kHz and the mean pre- and post-operative bone conduction threshold at 4kHz. A Student t-test was used to compare hearing results. RESULTS: Forty five were children reviewed at 1 year. Twelve (27%) were recommended second look tympanotomy, of which 10 had surgery; all were free of residual disease. At second look two children had ossiculoplasty performed, four had adhesions divided. Six children had formed a myringostapediopexy after their first surgery. The mean pre-op bone conduction threshold was 6.3dB for those having single stage surgery and 5.6dB for those having a second look and the post-operative thresholds were 7.8 and 10.2dB, respectively. The mean preoperative air conduction threshold was 32.6dB for single stage surgery and 31.1dB for staged surgery and at 1 year 29.2 and 40.8dB. This was a significant difference. After second look, the air conduction threshold was 34.5dB, and not significantly different from those who had single stage surgery. The mean pre-treatment 4kHz bone conduction threshold was 6.3 and 5.6dB for single stage surgery and second look tympanotomy and after surgery, respectively, 9.8 and 14.5dB. These changes are not statistically significant. CONCLUSION: The small cavity mastoidectomy approach allows meticulous removal of disease from the middle ear and for certain indications second look tympanotomy is recommended. Planned second look tympanotomy has demonstrated excellent early disease control as well as allowing timely management of any pathology affecting the middle ear sound transformation mechanism.

Adolescent↗
PubMed1980

The history of mastoid surgery.

Adam Politzer wrote this article on the history of mastoid surgery for inclusion in Volume II of his History of Otology, Enke Verlag, Stuttgart, 1913. Politzer reviews the decades before antibiotics when the simple or complete mastoidectomy was performed in cases of acute mastoiditis in which abscess formation was suspected; such timely surgery after prevented extensive osseous destruction and also often-fatal meningitis and sinus thrombosis. So-called "radical" surgery began when surgeons realized that simple exposure of the antrum was inadequate to control chronic infection involving the middle ear, ossicles, and meatal walls. "Modified radical" surgery evolved from the attempt to preserve hearing, canal plasty from the attempt to prevent postoperative canal stricture. Politzer describes the surgery designed to close the tympanic ostium of the Eustachian tube and the application of skin grafts to the operative sites.

Europe↗
PubMedDate not supplied

Probe-tube microphone measures in patients with open-mastoid surgery: real-ear-to-coupler differences and real-ear unaided responses.

Real-ear-to-coupler differences (RECDs) and real-ear unaided responses (REURs) were measured using a probe-tube microphone system in 15 patients who underwent open mastoid surgery. The results show that RECDs are significantly smaller at higher frequencies (1.5, 2.0, 3.0, 4.0 and 6.0 kHz) in mastoid ears. The intrasubject variability of RECDs measures in these patients is on average 2.6 dB larger than for controls. For REURs, mastoid surgery significantly reduced the mean peak resonant frequency without affecting the amplitude and bandwidth. In operated ears, mean resonant frequency is by a factor of 1.4 lower than that for normal ears. Reduced responses (negative gains) at frequencies above the resonance peak occurred in 7 out of the 15 patients. These reduced responses corresponded to the smaller RECD at the middle and high frequencies. The results support the need for individual RECD measures to be made in operated ears instead of using average values from normal subjects. Otherwise, real-ear measures of the aided response should be made for each patient with open-mastoid cavity and the fitting should be done in terms of the target response at the eardrum rather than by defining a target insertion gain.

Adolescent↗
PubMed1989

Open-cavity mastoid surgery: its effect on the acoustics of the external ear canal.

Temporal bone studies have demonstrated that a modified radical mastoidectomy changes the resonant characteristics of the external auditory canal, but the effect has not been reported in patients. In 12 patients, performing open-cavity mastoid surgery for cholesteatoma changed the mean peak resonant frequency of the external ear canal from 2.5 to 2.2 kHz (p less than 0.02). This is in comparison with creating a modified radical mastoid cavity in 6 temporal bones which changed the mean peak resonant frequency of the external ear canal from 3.9 to 1.9 kHz. It is concluded that open-cavity mastoid surgery in patients changes the acoustics of the external ear canal less than in temporal bone studies.

Acoustics↗
PubMed1976

Pneumocephalus following mastoid surgery: a report of two cases.

Two cases of spontaneous pneumocephalus following mastoid surgery are presented. In both cases a fistula from the mastoid ended blindly in an area of cerebritis without any definite abscess formation. Etiological factors are discussed with congenital dural defects suspected as the precipitating factor.

Adult↗
PubMed1989

An avoidable occupational hazard during mastoid surgery.

Conjunctival innoculation is a previously unrecognized hazard for the otologist during mastoid surgery. This experiment assess the spread of droplet contamination during temporal bone dissection. The results suggest that otologists and assistants should wear eye protection during exposure of the mastoid antrum by drilling.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Outcome of residual cholesteatoma and hearing in mastoid surgery.

OBJECTIVE: To review 12 years of the senior author's experience with mastoid surgery for cholesteatoma. DESIGN: Retrospective review. SETTING: Northwestern University Medical School. METHODS: Available records included 97 mastoid procedures for cholesteatoma: 54 with intact canal-wall and 43 canal-wall-down. MAIN OUTCOME MEASURES: Residual cholesteatoma, pure-tone audiometry, and speech audiometry were compared for both groups. RESULTS: Residual disease rate was 11 of 54 (20%) for intact canal-wall procedures and 2 of 43 (5%) for canal-wall-down procedures. Average follow-up was 2 years. Hearing was preserved postoperatively, and neither procedure demonstrated clear superiority in this regard. CONCLUSION: While canal-wall-down mastoidectomy provides a lower residual disease rate with equal hearing outcome, the role of intact wall mastoidectomy remains a viable choice in certain clinical situations.

Adult↗
PubMed2001

Morphometric analysis of anatomical relationships of the facial nerve for mastoid surgery.

Surgical anatomical relationships of the facial nerve (FN) with several landmarks used in mastoid surgery were studied in temporal bone axial high resolution CT scans of 90 patients (180 ears). The shortest distances between the FN and external auditory canal (EAC), sigmoid sinus (SS), posterior fossa dural plate (PFD), and joint of the bony EAC with the lateral surface of the mastoid (M) were measured. These measurements were also analysed in respect of pneumatization and side differences. On average, it was found that FN-EAC was 2.9 mm, FN-SS was 10.5 mm, FN-PFD was 7.3 mm and FN-M was 15.3 mm. FN-EAC was found to be longer in poorly pneumatized bones whereas other distances were longer in pneumatized bones. FN-M was found to be longer on the right side.

Adolescent↗
PubMed1991

Modified radical mastoid surgery for chronic ear disease.

The aim of surgery in chronic ear disease is to produce a dry, clean, safe, waterproof ear and to reconstruct the hearing. The techniques available are of the so-called "open" variety or "closed". This article avoids any controversy about the merits of each but presents a method of surgery which in most cases will fulfil the above aims. The techniques of mastoid surgery are well documented. In this article, the finer points are discussed with emphasis on the areas which if insufficiently treated, will lead to recurrence of disease and continuing discharge. These areas are the anterior epi-tympanum, the recess between the tympanic membrane and the anterior and inferior canal walls, the facial ridge and the sump that can form behind it, the sino-dural angle and the mastoid tip.

Audiometry, Pure-Tone↗
PubMed2004

Middle temporal artery flap in mastoid surgery.

OBJECTIVE: The objective of this study was to describe the anatomy of the middle temporal artery (MTA) flap and its application in mastoid surgery. STUDY DESIGN: A description of the anatomy and surgical technique. CONCLUSION: The middle temporal flap is extremely useful in lining mastoid cavities, especially those in which poor healing is anticipated. It is available in most cases and is easily harvested and inset. It is particularly useful in revision cases, if present.

Humans↗
PubMed2001

Measurements of drill-induced temperature change in the facial nerve during mastoid surgery: a cadaveric model using diamond burs.

The purpose of this study was to investigate the changes in temperature in the facial nerve that occur during mastoid drilling by the facial recess approach and to confirm the beneficial effects of constant irrigation while drilling. Mastoid drilling was performed on human cadaveric temporal bones by means of 4-mm diamond burs with and without irrigation. There were 6 subjects in each group. Changes in facial nerve temperature were recorded on a continuous-output monitor. Significant changes were found in temperature for both the irrigation and non-irrigation groups (p < .0001). Constant irrigation minimized the rise in temperature. Facial recess drilling poses a potential threat to cranial nerve VII via thermal injury. The temperature elevation in the non-irrigation group was significantly greater than that in the irrigation group and was greater than the tolerable limits of peripheral nervous tissue. This finding supports the need for constant irrigation during the approach to the facial recess in mastoid surgery.

Body Temperature↗
PubMed2001

Facial nerve monitoring in middle ear and mastoid surgery.

HYPOTHESIS: Intraoperative electromyographic facial nerve monitoring, long accepted as the standard of care in surgery for acoustic neuroma and other cerebellopontine angle tumors, may be of aid in middle ear and mastoid surgery. STUDY DESIGN: Retrospective series of 262 cases of middle ear/mastoid surgery in which monitoring was performed by a neurophysiologist. METHODS: Neurophysiological monitoring events were classified as mechanical or electrical. The voltages producing facial nerve stimulation were compiled and compared with observed facial nerve dehiscence. RESULTS: The most common use of monitoring was localization of the facial nerve by electrical stimulation (60%) or identification of mechanically evoked activity (39%). In 57 cases (36%), the first electrical stimulation event evoked a facial nerve response at less than 1 V threshold, indicating little or no bony covering. The minimum stimulation threshold throughout each of these cases was less than 1 V in 88 of the 159 cases (55%) in which stimulation was attempted. In contrast, the facial nerve was visibly dehiscent in only 35 cases (13%). Neurophysiological monitoring confirmed aberrant facial nerve course through the temporal bone in four cases resulting in cancellation of surgical treatment in two cases. Postoperative facial nerve function was preserved in all cases when present preoperatively. CONCLUSIONS: An electrical stimulation threshold of less than 1 V is a more useful criterion of dehiscence than observation under the operating microscope. The absence of monitoring events allows safe dissection. Monitoring can help locate the facial nerve, guide the dissection and drilling, and confirm its integrity, thereby allowing more definitive surgical treatment while preserving neural function.

Adolescent↗
PubMed1995

Eye protection during mastoid surgery.

A questionnaire was sent to all Full Members of the British Association of Otolaryngologists to ascertain whether and what type of eye protection surgeons and theatre nurses wear during mastoid surgery. Despite Department of Health recommendations only 58 per cent of surgeons and 19 per cent of theatre nurses routinely wear any form of eye protection.

Eye Protective Devices↗
PubMed1980

Drill- and suction-generated noise in mastoid surgery.

The air-conduction noise levels in the external and middle ear generated by drilling and suction during temporal bone surgery were measured. Variables included diamond burrs, cutting burrs, two different air drills (Hall and Stryker) an electric drill (Emesco), and drilling with and without suction irrigation. The results show that the single factor contributing the highest noise level is suction irrigation, which exposes the ipsilateral ear to noise levels averaging up to 107 dB (A). The average noise levels of drilling range from 65 to 96 dB (A) varying with the drill and burr used. Simultaneous drilling and suction irrigation generated noise levels ranging from 91 to 108 dB (A). Cutting burrs were found to be up to 9 dB (A) more intense than diamond burrs. Exposure to these noise levels may account for shifts in the hearing thresholds sometimes apparent in postoperative audiograms of mastoid surgery patients.

Humans↗