Atticotomy

BACKGROUD: Attic cholesteatomas can be exenterated by transcanal endoscopic ear surgery (TEES). In the limited operative field of exclusive transcanal endoscopic atticotomy, surgeons use either a piezosurgery scalpel or a drilling system to remove the posterior lateral bony wall of the epitympanum. We aimed to investigate the feasibility of using piezosurgery or microdrill for endoscopic atticotomy during exenteration of attic cholesteatomas. METHODS: This study is a retrospective chart review of patients diagnosed with attic cholesteatoma, who were treated by exclusive TEES...

The functional aspect of preservation of every healthy anatomical structure, particularly the ossicles, non-diseased mastoid cortex and middle ear mucosa, and to achieve this by transacanal endoscopic dual hand approach to middle ear, aditus and mastoid antrum with minimal posterior atticotomy and proximal aditotomy. The prospective study has been conducted over a period of 12 years from 2009 to 2021 in the Jorhat Medical College, Assam Medical College and Niramoy Hospital, Jorhat, Assam. Follow up was for a minimum of 4 years...

OBJECTIVE: To investigate the efficiency of additional intraoperative endoscopic inspection in reducing residual cholesteatoma in pediatric cholesteatoma involving the mastoid treated with classic canal-wall-up mastoidectomy and tympanoplasty. MATERIALS AND METHODS: 32 cases of pediatric cholesteatoma involving the mastoid were enrolled in this perspective study and treated with classic canal-wall-up mastoidectomy and tympanoplasty. Transmastoid posterior tympanotomy, atticotomy and transecting tendon of tympani tensor were conducted to achieve adequate visualization of hidden spaces in the middle ear...

This study aims to test the effectiveness and safety of exteriorization surgery comprising atticotomy and obliteration of the additus ad antrum, also referred to as attic exposition-antrum exclusion (AE-AE) surgery. This surgery combines otoendoscopy with surgical microscopy for the treatment of acquired pars flaccida cholesteatoma in stages Ib and II (according to the classification of the Japan Otological Society) present in the attic and the tympanic cavity. We reviewed a historical cohort of 65 patients...

Chronic otitis media is defined as the chronic inflammation of the mucoperiosteal lining lining of the middle ear cleft which presents with recurrent ear discharge through tympanic membrane perforation. The study was planned to evaluate the patency of the aditus ad antrum in cases of chronic otitis media mucosal type, and its correlation with various direct and indirect indicators of blocked aditus. The prospective longitudinal study was conducted on 100 patients with chronic otitis media mucosal type. The commonest complaint of patients was ear discharge (100%) followed by hearing impairment in 72% patients...

BACKGROUND: Transcanal endoscopic ear surgery enables surgeons to operate with few blind areas, and using an angled endoscope expands its usefulness. We have previously reported the usefulness of a 70° endoscope in transcanal endoscopic ear surgery, but no quantitative study has been performed. We quantitatively clarified the difference between a microscope and various endoscopes in the bone removal region, especially a 70° endoscope, in the transcanal approach. METHODS: A temporal bone model for ear surgery training was used to compare the use of a microscope, a 0° endoscope, a 30° endoscope, a 45°endoscope, and a 70° endoscope...

Swimming confers significant physical and mental health benefits to people but there is little evidence regarding the impact of mastoid surgery on this activity. Almost half of the patients (46.7%) swim less after mastoid surgery. Occasional swimmers are affected mostly. The need to protect the ear and dizziness are the main reasons to discontinue swimming. Acute incapacitating vertigo occurs in 8.9% patients during swimming. No difference in swimming frequency between patients with a closed or an open mastoid cavity was observed...

Surgical removal of tumor is the primary treatment of choice for glomus tympanicum (GT). However, because the tumor has abundant blood flow, bleeding control is crucial, and preoperative embolization may be performed. Here, we report the case of a 46-year-old female who visited our hospital with a complaint of right pulsatile tinnitus. A red pulsatile mass was found in the right tympanic cavity, and she was diagnosed with class B1 GT and subsequently underwent surgical treatment. We judged that bleeding could be controlled by intratympanic cavity manipulation alone and decided to perform transmeatal tumor resection without preoperative arterial embolization...

OBJECTIVE: To examine postoperative opioid-prescribing patterns following otologic surgery. STUDY DESIGN: Retrospective population-based descriptive study. SETTING: All hospitals in the Canadian province of Ontario. METHODS: Of all patients with advanced ear surgery between July 1, 2012, and March 31, 2019, 7 cohorts were constructed: tympanoplasty with or without ossiculoplasty (n = 7812), atticotomy/limited mastoidectomy (n = 1371), mastoidectomy (n = 3717), semicircular canal occlusion (SCO; n = 179), stapedectomy (n = 2735), bone-implanted hearing aid insertion (n = 280), and cochlear implant (n = 2169)...

We report a case of a chronic mesotympanic otitis media with a smelly purulent secretion from both ears and recurrent otalgia over the last five years in a six-year-old girl after swimming in the German Baltic Sea. Besides Staphylococcus aureus a non-O1/non-O139 Vibrio cholerae strain could be isolated from patient samples. An antibiotic therapy with ciprofloxacin and ceftriaxone was administered followed by atticotomy combined with tympanoplasty. We conclude that V. cholerae should not be overlooked as a differential diagnosis to otitis infections, especially when patients present with extra-intestinal infections after contact with brackish- or saltwater aquatic environments...

Objective: The clinical symptoms, imaging features and surgical treatment of congenital cholesteatoma are reported. Method: The clinical data of 20 patients with congenital cholesteatoma diagnosed and treated in our hospital from January 2016 to May 2018 were retrospectively analyzed, including the age of onset, clinical symptoms, signs, audiology, HRCT of temporal bone, surgical methods and so on. Result: In 20 patients with congenital cholesteatoma, the clinical manifestations were hearing loss in the affected ears, including 5 cases with ear fullness and 4 cases with tinnitus...

OBJECTIVES: To compare endoscopic transcanal approach to attic cholesteatoma with conventional microscopic transcanal technique METHODS: Seventy-eight patients diagnosed with attic cholesteatoma were randomly assigned into two groups-one undergoing endoscopic approach and the other microscopic technique. The two groups were compared in terms of area of exposure, access to hidden areas in terms of Middle Ear Structural Visibility Index (MESVI), intraoperative time, postoperative pain, vertigo, long-term hearing, and surgical outcomes...

With the popularity of exclusive transcanal endoscopic ear surgery, the need for a suitable and affordable surgical training model has grown. To develop an ex vivo animal model for exclusive endoscopic ear surgery. In an experimental study, we studied goat middle ear anatomy in 8 specimens to assess the similarity with the human middle ear as a model for two handed endoscopic ear surgery with endoscope holders. After confirming its suitability, we have developed a surgical training program for grommet insertion, canaloplasty, myringoplasty, butterfly tympanoplasty, ossiculoplasty, atticotomy...

The temporal bone is a complex anatomical structure and so preoperatively computed tomography (CT) of the temporal bone is important for choice of the surgical procedure. In this study, evaluation of the surgical difficulty to conduct transmastoid atticotomy with the coronary cut of CT temporal bone. Additional, attic pathology intraoperative is evaluated. The current research is a retrospective study of 79 patients with chronic suppurative otitis media (safe type) with the preoperative opacity of the attic in CT temporal bone...

OBJECTIVE: To assess the effect of tranexamic acid on intra-operative bleeding and surgical field visualisation. METHODS: Fifty patients undergoing various endoscopic ear surgical procedures, including endoscopic tympanoplasty, endoscopic atticotomy or mastoidectomy, endoscopic ossiculoplasty, and endoscopic stapedotomy, were randomly assigned to: a study group that received tranexamic acid or a control group which received normal saline. The intra-operative bleeding and operative field visualisation was graded using the Das and Mitra endoscopic ear surgery bleeding and field visibility score, which was separately analysed for the external auditory canal and the middle ear...

INTRODUCTION: Residual disease after cholesteatoma removal is still a challenge for the otorhinolaryngologist. Scheduled "second-look" surgery and, more recently, radiological screenings are used to identify residual cholesteatoma as early as possible. However, these procedures are cost-intensive and are accompanied by discomfort and risks for the patient. OBJECTIVE: To identify anamnestic, clinical, and surgery-related risk factors for residual cholesteatoma...

Objective: To compare the efficacy and safety between Bondy modified radical mastoidectomy (BMRM) and atticotomy for stage Ⅰ epitympanic cholesteatoma. Method: A retrospective analysis of 36 cases with stage Ⅰ epitympanic cholesteatoma was performed. According to different surgery methods, the cases were divided into the atticotomy group (21 cases) and the BMRM group (15 cases). Hearing function, the dry ear ratio after two months of the surgery, and the epithelial time were observed. The complications for the retraction of tympanic membrane, residual or recurrence of cholesteatoma, and otorrhea were analyzed...

OBJECTIVE: To investigate future surgery for chronic ear disease in children who underwent tympanostomy tube (TT) placement, compared with non-surgically treated patients and healthy controls. STUDY DESIGN: Retrospective population-based cohort study. SETTING: All hospitals in the Canadian province of Ontario. PATIENTS/INTERVENTION: Of children aged 18 years and younger, three cohorts were constructed: 1) TT: patients who had undergone at least one TT procedure (n = 193,880), 2) No-TT: patients with recurrent physician visits for middle ear concerns who did not undergo TT (n = 203,283), and 3) Control: an age-sex matched control group who had not had TT or physician visits for recurrent middle ear concerns (n = 961,168)...

OBJECTIVE: To investigate future surgery for chronic ear disease in children who underwent tympanostomy tube (TT) placement, compared with non-surgically treated patients and healthy controls. STUDY DESIGN: Retrospective population-based cohort study. SETTING: All hospitals in the Canadian province of Ontario. PATIENTS/INTERVENTION: Of children aged 18 years and younger, three cohorts were constructed: 1) TT: patients who had undergone at least one TT procedure (n = 193,880), 2) No-TT: patients with recurrent physician visits for middle ear concerns who did not undergo TT (n = 203,283), and 3) Control: an age-sex matched control group who had not had TT or physician visits for recurrent middle ear concerns (n = 961,168)...

OBJECTIVE: To show the efficiency of using transmastoid atticotomy (TMA) endoscopy on the outcome of ossiculoplasty in patients with cholesteatoma. TMA is often performed as part of the surgical management of patients with middle ear cholesteatoma extending to the epitympanum. TMA can also be used as an access for endoscopic view to confirm the right alignment and stability of the ossicular prosthesis because the reconstruction of the tympanic membrane will obscure the visualization of the prosthesis...