Fermi, Matteo; Siggemann, Till; Melchiorri, Claudio; Bonali, Marco; Niederhauser, Laura; Caversaccio, Marco; Presutti, Livio; Anschuetz, Lukas (2022). Revision canal-wall down surgery: comparison of surgical outcomes with three different techniques. European archives of oto-rhino-laryngology, 279(4), pp. 1731-1739. Springer 10.1007/s00405-021-06829-y
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OBJECTIVE
This study aimed to analyze the role of the endoscope in revision canal-wall down (CWD) tympanomastoid surgery and compare its use to the more traditional microscopic approach. Moreover, we aim to investigate functional outcomes of revision surgeries in a cohort of two tertiary reference centers.
METHODS
A total of 103 patients undergoing revision surgery after previous CWD tympanomastoidectomy were included in the present study and divided in three groups according to the surgical technique used: endoscope exclusive (n = 22), combined (n = 35) and microscope exclusive (n = 46). Data regarding surgical indications, pre-operative clinical and audiological assessments, intraoperative findings and surgical considerations were extracted. During follow-up, data regarding anatomic and audiologic outcomes were collected and persistence or recurrence of the disease assessed.
RESULTS
The most frequent sites of cholesteatoma recurrence or persistence was the anterior epitympanum. There was a statistically significant ABG improvement of - 6.02 dB HL (95% CI - 8.87 to - 3.16, p < 0.001) between pre-operative and postoperative ABG, without significant effect of surgical technique. During follow-up, no significant differences regarding disease or otorrhea control were observed. Duration of surgery and hospitalization was shorter in the endoscopic cohort without statistical significance. Intra- and postoperative complications were lower in the endoscopic group.
CONCLUSION
Revision CWD surgery can take advantage of the endoscope as a minimally invasive exclusive or adjunct tool to traditional microscopic procedures. Outcome measures of endoscopic revision CWD surgery showed anatomic and functional results comparable to those of the microscopic group. The complication rate, the duration of surgery and hospitalization were favorable in the endoscopic group.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
07 Faculty of Human Sciences > Institute of Psychology > Cognitive Psychology, Perception and Methodology 04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ear, Nose and Throat Disorders (ENT) |
UniBE Contributor: |
Niederhauser, Laura, Caversaccio, Marco, Anschütz, Lukas Peter |
Subjects: |
100 Philosophy > 150 Psychology 600 Technology > 610 Medicine & health |
ISSN: |
0937-4477 |
Publisher: |
Springer |
Language: |
English |
Submitter: |
Stefan Weder |
Date Deposited: |
24 Jan 2022 10:52 |
Last Modified: |
05 Dec 2022 16:00 |
Publisher DOI: |
10.1007/s00405-021-06829-y |
PubMed ID: |
33904981 |
Uncontrolled Keywords: |
Canal-wall down revision Cholesteatoma Endoscopic ear surgery Outcome Revision surgery |
BORIS DOI: |
10.48350/163449 |
URI: |
https://boris.unibe.ch/id/eprint/163449 |
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