Tympanomastoidectomy: Planned Second-Look Tympanotomy

Dawes, Patrick J. D.; Al-Qudah, Mohannad
June 2009
Journal of Otolaryngology -- Head & Neck Surgery;Jun2009, Vol. 38 Issue 3, p311
Academic Journal
Objective: To review the outcome following surgery for cholesteatoma/retraction pocket disease where second-look tympanotomy was recommended for selected patients. Design: Retrospective outcome analysis following canal wall down mastoid surgery for cholesteatoma/retraction pocket disease. Subjects: The study included 158 patients (163 ears) operated on between 1993 and 2003. Data were collected on the recommendation for second-look tympanotomy, the findings at second-look tympanotomy, and hearing threshold. Results: Second-look tympanotomy was recommended for 36 patients, 32 had surgery, and 30 were free of residual disease. The respective mean pre- and postoperative bone conduction threshold was 8.9 dB and 18 dB for single-stage surgery and 15.8 dB and 16.8 dB for second-look tympanotomy. The mean preoperative air--bone gap (0.5, 1, 2, 4 kHz) was 27.1 dB for single-stage surgery and 27.9 dB for staged surgery. The 1-year air--bone gap was 24.6 dB and 28.6 dB, respectively. Conclusion: Planned second-look tympanotomy demonstrated excellent early disease control and allowed management of the middle ear pathology.


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