Comparing the Incidence of Residual Cholesteatoma Using two Canal Wall Down and Endoscopic-assisted Intact Canal Wall Tympanomastoidectomy Methods

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BORGHEI PEDRAM; NEMATI SHADMAN; Adel Suzan; NIKKHAH MEHDI

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Journal: JOURNAL OF GUILAN UNIVERSITY OF MEDICAL SCIENCES Year:2020 | Volume:29 | Issue:115 Page(s): 50-57

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Title

Comparing the Incidence of Residual Cholesteatoma Using two Canal Wall Down and Endoscopic-assisted Intact Canal Wall Tympanomastoidectomy Methods

Author(s)

BORGHEI PEDRAM | NEMATI SHADMAN | Adel Suzan | NIKKHAH MEHDI | Issue Writer Certificate

Keywords

Endoscopic ear surgeryQ1

CholesteatomaQ3

Mas toid surgeryQ1

Abstract

Background For many years, Canal Wall Down (CWD) tympanomastoidectomy has been the gold standard for treatment of Cholesteatoma; however, this method has long-term complications for the patients. The Intact Canal Wall (ICW) tympanomastoidectomy has relatively lower complications, but access to the middle-ear recesses is difficult in this method. Therefore, endoscopy is used to visualize the underexposed recesses. Objective This study aims to compare the incidence of residual Cholesteatoma using the two methods of CWD and endoscopic-assisted ICW. Materials and Methods In this prospective randomized clinical trial, participants were 40 patients with Cholesteatoma in the middle ear and mastoid who were candidates for tympanomastoidectomy. They were randomly divided into two groups. In the first group, ICW was performed with endoscopic assisted visualization, while in the second group, conventional CWD technique was performed without ossicular reconstruction. All the patients were microscopically examined at 3, 6, 9 and 12 months after surgery. Revision middle ear surgery and possible ossicular reconstruction under local anesthesia were performed one year after the surgery. The presence of Cholesteatoma pearl in the middle-ear, evaluated by using a 2. 7mm 30° endoscope, was recorded as the sign of residual Cholesteatoma. Fisher’ s exact test and Mann-Whitney U test were used for statistical analysis. Significance level for the tests was set at 5%. Results The incidence of residual Cholesteatoma was not statistically significant between the two groups (P>0. 05). In each group, 20% (n=4) had residual Cholesteatoma. The difference in time interval from the first to second surgery was not statistically significant between the study groups (P>0. 05). Conclusion Endoscopic-assisted ICW tympanomastoidectomy is comparable with CWD tympanomastoidectomy in eradication of Cholesteatoma, having possibly fewer complications. It is recommended that more studies be conducted with a larger sample size and longer follow-up period.

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APA: Copy

BORGHEI, PEDRAM, NEMATI, SHADMAN, Adel, Suzan, & NIKKHAH, MEHDI. (2020). Comparing the Incidence of Residual Cholesteatoma Using two Canal Wall Down and Endoscopic-assisted Intact Canal Wall Tympanomastoidectomy Methods. JOURNAL OF GUILAN UNIVERSITY OF MEDICAL SCIENCES, 29(115 ), 50-57. SID. https://sid.ir/paper/411827/en

Vancouver: Copy

BORGHEI PEDRAM, NEMATI SHADMAN, Adel Suzan, NIKKHAH MEHDI. Comparing the Incidence of Residual Cholesteatoma Using two Canal Wall Down and Endoscopic-assisted Intact Canal Wall Tympanomastoidectomy Methods. JOURNAL OF GUILAN UNIVERSITY OF MEDICAL SCIENCES[Internet]. 2020;29(115 ):50-57. Available from: https://sid.ir/paper/411827/en

IEEE: Copy

PEDRAM BORGHEI, SHADMAN NEMATI, Suzan Adel, and MEHDI NIKKHAH, “Comparing the Incidence of Residual Cholesteatoma Using two Canal Wall Down and Endoscopic-assisted Intact Canal Wall Tympanomastoidectomy Methods,” JOURNAL OF GUILAN UNIVERSITY OF MEDICAL SCIENCES, vol. 29, no. 115 , pp. 50–57, 2020, [Online]. Available: https://sid.ir/paper/411827/en

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