Correlation of pre-operative computed tomography, intra-operative findings and surgical outcomes in revision tympanomastoidectomy.
To correlate pre-operative computed tomography findings, intra-operative details and surgical outcomes with cholesteatoma recurrence in revision tympanomastoidectomy.This retrospective, non-randomised, single-institution cohort study included 42 patients who underwent pre-operative computed tomography imaging and revision surgery for recurrent chronic otitis media. Twelve disease localisations noted during revision surgery were correlated with pre-operative temporal bone computed tomography scans. A matched pair analysis was performed on patients with similar intra-operative findings, but without pre-operative computed tomography scans.Pre-operative computed tomography identified 25 out of 31 cholesteatoma recurrences. Computed tomography findings correlated with: recurrent cholesteatoma when attic opacification and ossicular chain involvement were present; and revision surgery type. Sinodural angle disease, posterior canal wall erosion and dehiscent dura were identified as predictors of canal wall down tympanomastoidectomy. Patients with pre-operative computed tomography scans had a higher rate of cholesteatoma recurrence, younger age at diagnosis of recurrent disease, more revision surgical procedures and less time between previous and revision surgical procedures (all p < 0.05).Pre-operative imaging and intra-operative findings have important clinical implications in revision surgery for chronic otitis media. Performing pre-operative computed tomography increases diagnosis accuracy and reduces the time required to diagnose recurrent disease.
This is an abstract of the clinical research article “Correlation of pre-operative computed tomography, intra-operative findings and surgical outcomes in revision tympanomastoidectomy.” This clinical research article was published in the medical journal The Journal of laryngology and otology on 2021-01-07 and has been categorised as belonging to the clinical specialty of ENT. To read the full clinical research article or obtain a PDF (if available) use the links directly above. To discover more of the latest ENT clinical research articles from the medical journal The Journal of laryngology and otology please click the link below. For more of the latest ENT research articles from other leading medical journals click the link that says ENT next to the stethoscope icon at the top of the page. You can further filter clinical research articles by sub-specialties within ENT using the navigation menu at the top of the page.