Abstract
Objective: To observe the multiplicity of chronic otitis media mastoiditis foci and to explore their treatment through functional surgery.
Method: Sixty patients with chronic otitis media mastoiditis were hospitalized and given functional surgeries that consisted of modified radical mastoidectomy, tympanoplasty, and ossicular chain reconstruction between January 2008 and December 2009. The operation emphasized the preservation and reconstruction of the ear function.
Results: The foci found during operation were cholestoma, cholesterol cyst, sclerosis, mucosa inflammation, and bone pathological changes. Three cases were found to involve only 1 type of foci; 15 cases were found to have 2 types of foci coexisted; 3 kinds of foci were found to coexist in 37 cases, and more than 3 kinds of foci were found to coexist in 5 cases. There were defects in facial nerve canal in 19 cases, and fistula on labyrinth in 3 cases. Postsurgery follow-up showed the dry ear time ranged from 1 to 3 months, 1.5 months on average. The difference of the air-bone conduction gap between preoperation 34.95 ± 7.52 dB and postoperation 15.27 ± 5.00 dB was statistically significant (t = 3.68, P < .01).
Conclusion: Chronic otitis media and mastoiditis have foci including cholestoma, cholesterol cyst, sclerosis, mucosa inflammation, and bone pathological changes. Most of the cases show more than 1 focus and some even involve all of the 5 foci. Skillful microscopic technique is the key to treatment and functional surgery.
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