Clinical Analysis Of Otologic Surgical Procedures For Chronic Suppurative Otitis Media

Objective:To study the otologic surgical procedures of chronic suppurative otitis media and analyze clinical features of two different surgical procedures.Methods:Seventy-three cases (73 ears) of first stage tympanomastoidectomy for chronic suppurative otitis media including osteitis and cholesteatoma (total 248 cases) followed up for 6 months between 2007 to June 2010 were analyzed retrospectively. The extension of lesions,quantity of surgeries,duration of getting dry ear,hearing level and recurrence of cholesteatoma were discussed on the procedures of canal wall up (CWU) and canal wall down (CWD) tympanomastoidectomy.Results:On the contrast of the extension of lesions, CWD group involving mastoid,antrum tympanicum,attic and post tympanum was much wider than CWU group almost limiting in mastoid,antrum tympanicum and attic. The quantity of CWD and CWU increased gradually, but much more obvious in CWU. On the contrast of duration of getting dry ear, CWD group (9.2±3.0 weeks) was longer than CWU group (6.2±2.4 weeks) (F=20.57, P<0.01). On the contrast of improved hearing level, CWU group was better than CWD group(F=6.32, P<0.05; F=8.63, P<0.01). As the recurrence rate, there was no significant difference between CWD group (12.5%) and CWU group (16.7%) (x2=0.162,P>0.05).Conclusions:Although the fundament of surgical treatment for chronic suppurative otitis media is still security, with the development of otologic instruments and surgical skills, to reserve or restore hearing as much as possible has become an important goal. Therefore, always carrying out canal wall down tympanomastoidectomy is not practical, surgical procedures ought to begin with CWU and should be changed according to the founding of middle ear during operation.