Endoscopic ear surgery in the treatment of chronic otitis media with atelectasis.
Atelectasis otitis media
Endoscopic ear surgery
Middle ear endoscopy
Tympanic membrane retraction
Journal
European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
ISSN: 1434-4726
Titre abrégé: Eur Arch Otorhinolaryngol
Pays: Germany
ID NLM: 9002937
Informations de publication
Date de publication:
10 Aug 2024
10 Aug 2024
Historique:
received:
22
04
2024
accepted:
12
07
2024
medline:
10
8
2024
pubmed:
10
8
2024
entrez:
10
8
2024
Statut:
aheadofprint
Résumé
Atelectasis otitis media (AtOM) is a chronic condition where the tympanic membrane (TM) becomes retracted towards the middle ear and the ossicular chain. Surgical treatment for this condition could be indicated based on stage of atelectasis, patient's clinical condition and hearing loss. Over the years, AtOM has been treated with various types of tympanoplasty under microscopic view. The aim of this study is to present the results of endoscopic ear surgery in AtOM. Forty-five patients who underwent endoscopic trans-canal tympanoplasty were included in the study. Preoperative features, intraoperative findings and postoperative outcomes were collected. Preoperatively, none of the study's patients were classified with a Sadè Grade I, whereas grades II, III and IV were 3 (6.6%), 23 (32.1%) and 19 (67.8%) respectively. The 3 patients with Sadè grade II showed a conductive hearing loss higher than 20 dB and a continuous ear fullness, therefore they were surgically treated. The postoperative graft success rate was estimated at 95.5%. During follow-up, 2 patients showed a TM perforation (at 6 and 12 months after surgery) whereas 1 patient experienced a recurrence of atelectasis in the TM (16 months after surgery). The overall success rate at the final follow-up was calculated at 88.8%. The average preoperative air-conduction threshold was 51.1 ± 21.5, which reduced to 34.6 ± 22.1 (p = 0.04) at follow-up. The preoperative air-bone gap decreased from 28 ± 7.2 to 11.8 ± 10 (p = 0.002) after surgery. Atelectasis otitis media might be suitable for exclusive endoscopic surgical treatment, as it appears to exhibit a low recurrence rate and promising audiological outcomes.
Identifiants
pubmed: 39126509
doi: 10.1007/s00405-024-08845-0
pii: 10.1007/s00405-024-08845-0
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024. The Author(s).
Références
Urík M, Tedla M, Hurník P (2021) Pathogenesis of retraction pocket of the tympanic membrane—a narrative review. Medicina (Kaunas) 57:425
doi: 10.3390/medicina57050425
pubmed: 33924803
Bayoumy AB, Veugen CCAFM, van der Veen EL, Bok JM, de Ru JA, Thomeer HGXM (2022) Management of tympanic membrane retractions: a systematic review. Eur Arch Otorhinolaryngol 279:723–737
doi: 10.1007/s00405-021-06719-3
pubmed: 33689022
Yoshida S, Seki S, Sugiyama T, Kikuchi S, Yoshida N, Iino Y (2022) Comparative study on adhesive otitis media and pars tensa cholesteatoma in children. Auris Nasus Larynx 49:790–796
doi: 10.1016/j.anl.2022.02.007
pubmed: 35248415
Lee JH, Hong SM, Kim CW, Park YH, Baek SH (2015) Attic cholesteatoma with tiny retraction of pars flaccida. Auris Nasus Larynx 42:107–112
doi: 10.1016/j.anl.2014.08.006
pubmed: 25199742
Immordino A, Salvago P, Sireci F, Lorusso F, Immordino P, Saguto D, Martines F, Gallina S, Dispenza F (2023) Mastoidectomy in surgical procedures to treat retraction pockets: a single-center experience and review of the literature. Eur Arch Otorhinolaryngol 280:1081–1087
doi: 10.1007/s00405-022-07573-7
pubmed: 35947150
Noij KS, Noij DP, Borgstein J (2017) Healing of the tympanic membrane after surgical intervention for atelectasis of the middle ear in sixty-two adults. Clin Otolaryngol 42:450–454
doi: 10.1111/coa.12614
pubmed: 26725586
Magliulo G, de Vincentiis M, Iannella G, Ciofalo A, Manno A, Pasquariello B, Angeletti D, Pace A, Gulotta G, Polimeni A (2018) Eustachian tube evaluation in patients with obstructive sleep apnea syndrome. Acta Otolaryngol 138:159–164
doi: 10.1080/00016489.2017.1385846
pubmed: 28990834
Gey A, Reiber J, Honigmann R, Zirkler J, Rahne T, Plontke SK (2023) The rate of Eustachian tube dysfunction in adult patients with chronic inflammatory middle ear disease is low. Otol Neurotol 44:305-e310
doi: 10.1097/MAO.0000000000003852
Yoshida S, Seki S, Sugiyama T, Kikuchi S, Iino Y (2022) Clinical characteristics of atelectatic eardrums and adhesive otitis media in children. Int J Pediatr Otorhinolaryngol 159:111188
doi: 10.1016/j.ijporl.2022.111188
pubmed: 35653949
Sadé J (1993) Treatment of cholesteatoma and retraction pockets. Eur Arch Otorhinolaryngol 250:193–199
doi: 10.1007/BF00171523
pubmed: 8369113
Todd NW (2007) Pars flaccida retraction and mastoid size: relationship in clinically normal specimens. J Laryngol Otol 121:1020–1024
doi: 10.1017/S0022215107006305
pubmed: 17319992
Ulku CH (2017) Endoscopy-assisted ear surgery for treatment of chronic otitis media with cholesteatoma, adhesion, or retraction pockets. J Craniofac Surg 28:1017–1020
doi: 10.1097/SCS.0000000000003671
pubmed: 28277483
Angeletti D, Pace A, Iannella G, Rossetti V, Colizza A, Di Gioia C, Magliulo G (2020) Tympanic cholesterol granuloma and exclusive endoscopic approach. Am J Case Rep 21:e925369
doi: 10.12659/AJCR.925369
pubmed: 32960877
pmcid: 7520131
Li B, Zhou L, Wang M, Wang Y, Zou J (2021) Endoscopic versus microscopic surgery for treatment of middle ear cholesteatoma: a systematic review and meta-analysis. Am J Otolaryngol 42:102451
doi: 10.1016/j.amjoto.2020.102451
pubmed: 33360773
Magliulo G, Iannella G (2018) Endoscopic versus microscopic approach in attic cholesteatoma surgery. Am J Otolaryngol 39:25–30
doi: 10.1016/j.amjoto.2017.10.003
pubmed: 29037582
Crotty TJ, Cleere EF, Keogh IJ (2023) Endoscopic versus microscopic type-1 tympanoplasty: a meta-analysis of randomized trials. Laryngoscope 133:1550–1557
doi: 10.1002/lary.30479
pubmed: 36349835
Iannella G, Pace A, Greco A, Polimeni A, Maniaci A, Mucchino A, Lechien JR, Saibene AM, Mat Q, Gargula S, Fakhry N, Simon F, Gioacchini FM, Re M, Magliulo G (2023) Endaural microscopic approach versus endoscopic transcanal approach in treatment of attic cholesteatomas. Am J Otolaryngol 44:103860
doi: 10.1016/j.amjoto.2023.103860
pubmed: 36996516
Nair S, Aishwarya JG, Vasu PK, Karthikeyan A, Shalini M (2022) Outcomes of totally endoscopic versus microscopic techniques in middle ear cholesteatoma: a systematic review and meta-analysis. Indian J Otolaryngol Head Neck Surg 74:4200–4211
doi: 10.1007/s12070-021-02869-2
pubmed: 36742509
Stefan I, Stefanescu CD, Vlad AM, Zainea V, Hainarosie R (2023) Postoperative outcomes of endoscopic versus microscopic myringoplasty in patients with chronic otitis media—a systematic review. Medicina (Kaunas) 59:1074
doi: 10.3390/medicina59061074
pubmed: 37374278
Alicandri-Ciufelli M, Marchioni D, Kakehata S, Presutti L, Villari D (2016) Endoscopic management of attic cholesteatoma: long-term results. Otolaryngol Clin North Am 49:1265–1270
doi: 10.1016/j.otc.2016.05.015
pubmed: 27565391
Iannella G, Angeletti D, Manno A, Pasquariello B, Re M, Magliulo G (2018) Malleostapedotomy in stapes revision surgery: is an endoscopic approach possible? Laryngoscope 128:2611–2614
doi: 10.1002/lary.27206
pubmed: 29658107
Parab SR, Khan MM (2019) Endoscopic management of tympanic membrane retraction pockets: a two handed technique with endoscope holder. Indian J Otolaryngol Head Neck Surg 71:504–511
doi: 10.1007/s12070-019-01682-2
pubmed: 31750111
pmcid: 6838262
Guo YN, Qian M, Li J, Xu J, Chen H, Zhang H (2022) Clinical retrospective study on the efficacy and safety of endoscopic ear surgery for adhesive otitis media. Ann Transl Med 10:1211
doi: 10.21037/atm-22-4831
pubmed: 36544640
pmcid: 9761154
Marchioni D, Alicandri-Ciufelli M, Molteni G, Genovese E, Presutti L (2010) Endoscopic tympanoplasty in patients with attic retraction pockets. Laryngoscope 120:1847–1855
doi: 10.1002/lary.21069
pubmed: 20623791
Kitoh R, Nishio SY, Sato H et al (2024) Research group on intractable hearing disorders and Japan audiological society. Clinical practice guidelines for the diagnosis and management of acute sensorineural hearing loss. Auris Nasus Larynx 51(4):811–821
doi: 10.1016/j.anl.2024.06.004
pubmed: 38968877
Lou Z (2021) Endoscopic full-thickness cartilage-perichondrium double graft myringoplasty in adhesive perforation: retrospective case series. Acta Otolaryngol 141:14–18
doi: 10.1080/00016489.2020.1814406
pubmed: 32921208
Ciofalo A, Zambetti G, Romeo M, Vestri AR, Iannella G, Re M, Magliulo G (2015) Taste and olfaction in middle ear surgery. Ann Otol Rhinol Laryngol 124:312–316
doi: 10.1177/0003489414555900
pubmed: 25358610
Honnurappa V, Mahajan N, Vijayendra VK, Vassiliu S, Redleaf M (2023) Management of attic retraction pockets. J Laryngol Otol 137(11):1272–1276
doi: 10.1017/S002221512300083X
pubmed: 37203214
Spinos D, Mallick S, Judd O (2022) Management of retraction pockets: historic and novel approaches. J Laryngol Otol 136(7):582–587
doi: 10.1017/S0022215121004321
pubmed: 34991748
Iannella G, De Vincentiis M, Greco A, Vicini C, De Vito A, Meccariello G, Cammaroto G, Pelucchi S, Magliulo G (2019) Endoscopic approach in second stage ossicular chain reconstruction. Am J Otolaryngol 40:735–742
doi: 10.1016/j.amjoto.2019.07.004
pubmed: 31296351