Bartel Ricardo, Cruellas Francesc, Garcia-Wagner Miguel, Hamdan Miriam, Huguet Gabriel, Mesalles Marta, Penella Anna
Otolaryngology Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, Barcelona, Spain.
International Working Group on Endoscopic Ear Surgery (IWGEES).
Acta Otolaryngol. 2023 Apr;143(4):280-283. doi: 10.1080/00016489.2023.2184863. Epub 2023 Mar 10.
Chronic mucosal otitis media is a very common ear disease for which patients attend otolaryngology clinics. Most of these patients present with actively discharging ears.
AIMS/OBJECTIVES: This study aims to observe the middle ear space pathology and obtain surgical outcomes as a treatment for patients with advanced chronic mucosal otitis media with a transcanal endoscopic ear surgery approach.
A prospective study was designed, and patients suffering from chronic mucosal otitis media in the active suppurative phase with an air-bone gap larger than 20 dB were included.
70 operated ears were included. Underlying macroscopic pathology within the middle ear space was observed: Middle ear granulomas at 58.6%; Tympanosclerosis 41.4%. Blockage of the tympanic isthmus was evaluated, obtaining a blockage rate of 81.4%. At 12 months of evaluation after surgery, a postoperative ABG < 20 dB was achieved in 85.7% of the operated ears. An overall closed tympanic membrane was obtained in 88.6% of the patients.
This prospective cohort study shows the short-term efficacy of transcanal endoscopic type 3 tympanoplasty with mastoid preservation for managing advanced chronic mucosal otitis media. Clinical trials are required to give more evidence to the present matter.
慢性黏膜性中耳炎是一种非常常见的耳部疾病，患者常前往耳鼻喉科门诊就诊。这些患者大多表现为耳部有活动性流脓。
本研究旨在观察中耳腔病理情况，并通过经耳道内镜耳科手术方法，获得晚期慢性黏膜性中耳炎患者的手术治疗效果。
设计了一项前瞻性研究，纳入处于化脓活动期、气骨导差大于20dB的慢性黏膜性中耳炎患者。
纳入70只接受手术的耳朵。观察到中耳腔内潜在的宏观病理情况：中耳肉芽肿占58.6%；鼓室硬化占41.4%。评估了鼓室峡部阻塞情况，阻塞率为81.4%。术后12个月评估时，85.7%的手术耳术后气骨导差<20dB。88.6%的患者鼓膜整体愈合。
这项前瞻性队列研究显示了保留乳突的经耳道内镜3型鼓室成形术治疗晚期慢性黏膜性中耳炎的短期疗效。需要进行临床试验以进一步证实这一问题。
