The importance of tympanic cavity revision during tympanoplasty

DOI: https://doi.org/10.29296/25877305-2020-12-15
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Issue: 
12
Year: 
2020

V. Saidulaev(1, 2), Candidate of Medical Sciences; V. Shpotin(1, 2), MD; D. Fernando(1, 2),
Candidate of Medical Sciences; V-Kh. Saidulaev(3) (1)Astrakhan Branch, National Medical Research Center of
Otorhinolaryngology, Federal Biomedical Agency of Russia, Astrakhan (2)Astrakhan State Medical University
(3)Acad. I.P. Pavlov Ryazan State Medical University

The frequency of repeat surgical interventions in patients with chronic suppurative otitis media is associated with many factors, including neglect of careful revision of all parts of the middle ear. This paper assesses the results of revising the inner surface of the tympanic membrane and the tympanic cavity during primary tympanoplasties. Subjects and methods. A total of 123 patients diagnosed with chronic tubotympanic suppurative otitis media were operated on in January 2017 to December 2019. Intraoperative findings were analyzed during revision surgery. Results. Classical refreshing of the edges of the defect was insufficient to completely remove the epidermis from the inner surface of the tympanic membrane remnants in 12 (9.8%) cases. The epidermis extended along the posterior surface of the handle of the malleus, the long process of the incus, and the posterior crus of the stapes, reaching the pyramidal process in 3 (2.4%) cases. Hypotympanic and protympanic epidermal growth was observed in 2 (1.6%). Conclusion. Thorough revision of all parts of the tympanic cavity, including the inner surface of the tympanic membrane, is an important condition for a good result of surgery and prevention of disease recurrence.
Keywords: 
otorhinolaryngology
surgery
chronic suppurative otitis media
revision. tympanoplasty
tympanic membrane

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References: 
  1. Baranov K.K., Bogomil'skij M.R., Minasjan V.S. Sovremennye podhody k diagnostike i lecheniju obostrenij hronicheskogo srednego gnojnogo otita u detej. Vestnik RGMU. 2015; 1: 41–3 [Baranov K.K., Bogomilskiy M.R., Minasyan V.S. Current Approaches to Diagnosis and Treatment of Exacerbation of Chronic Suppurative Otitis Media in Children. Bulletin of RSMU. 2015; 1: 41–3 (in Russ.)].
  2. Sambulov V.I., Tjukin V.Ju. Sovremennye aspekty diagnostiki i hirurgicheskogo lechenija detej s hronicheskim gnojnym srednim otitom. Rossijskaja otorinolaringologija. 2004; 5: 160–3 [Sambulov V.I., Tyukin V.Yu. Sovremennye aspekty diagnostiki i khirurgicheskogo lecheniya detei s khronicheskim gnoinym srednim otitom. Rossiiskaya otorinolaringologiya. 2004; 5: 160–3 (in Russ.)].
  3. Wallis S., Atkinson H., Coatesworth A.P. Chronic otitis media. Postgrad Med. 2015; 127 (4): 391–5. DOI: 10.1080/00325481.2015.1027133
  4. Ahmedov Sh.M. Metod timpanoplastiki u bol'nyh mezotimpanitom. Rossijskaja otorinolaringologija. 2014; 3 (70): 6–11 [Akhmedov Sh.M. Tympanoplasty technique for mesotympanitis treatment. Rossiiskaya otorinolaringologiya. 2014; 3 (70): 6–11 (in Russ.)].
  5. Dave V., Sharma S. Comparative Analysis of Fascia Lata and Cartilage Graft in Revision Type 1 Tympanoplasty. Indian J Otolaryngol Head Neck Surg. 2019; 71 (2): 1232–7. DOI: 10.1007/s12070-018-1286-7
  6. Bhardwaj B., Singh J. Comparative Study of Hearing Improvement of Type 1 Tympanoplasty Using Temporalis Fascia and Conchal Cartilage as Graft Material. Indian J Otolaryngol Head Neck Surg. 2019; 71 (2): 1174–8. DOI: 10.1007/s12070-018-1248-0
  7. Kaylie D.M., Gardner E.K., Jackson C.G. Revision chronic ear surgery. Otolaryngol Head Neck Surg. 2006; 134 (3): 443–50. DOI: 10.1016/j.otohns.2005.10.044