No4(4) 2021
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DOI 10.37219/2528-8253-2021-4-31 |
Berezniuk IV, Kovtunenko OV, Berezniuk VV
Features of combined endoscopic tympanoplasty in children with chronic
otitis media with cholesteatoma |
Berezniuk Ihor V.
Dnipropetrovsk Oblast Children's Hospital
Head of the pediatric otolaryngology department
ORCID ID: https://orcid.org/0000-0002-2117-3790
Kovtunenko Oleksandr
Dnipro State Medical University
Head of the Department of Otorhinolaryngology
Doctor of Medical Sciences, Professor
Email: lor@dsma.dp.ua
ORCID ID: https://orcid.org/0000-0002-0562-7684
Scopus Author ID: 57215498685
Berezniuk Volodymyr
Dnipro State Medical University
Professor of the Department of Otorhinolaryngology
Doctor of Medical Sciences, Professor
Email: otologg@gmail.com
ORCID ID: https://orcid.org/0000-0003-0336-9893 |
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Abstract
Topicality: Chronic purulent otitis media is a disease that is often
encountered in everyday practice by otolaryngologists. To date, the full
rehabilitation of the middle ear in pediatric practice has caused much
debate about the method of surgery and remains a difficult surgical task.
Aim: to develop a more effective combined method of endoscopic
microsurgery in children with chronic otitis media with cholesteatoma.
Materials and methods: examined 52 children aged from 2 to 12 years,
operated on a closed variant of tympanoplasty for cholesteatoma otitis.
Patients were divided into 2 groups: 1st group (comparison), which used the
standard technique of closed variant of surgery with retroauricular incision
using an operating microscope (33 patients); and the 2nd group (main), where
the combined surgery with retroauricular incision with the using of a
microscope and endoscope and endoaural drainage of the antrum was performed
in 19 patients.
Results: We conducted an analysis of different types of tympanoplasty
in a closed variant of tympanoplasty in children with cholesteatoma otitis
and endoaural drainage of the antrum or without it. In the main group, the
number of secondary engraftment of the neotympanic membrane decreased 3.4
times, residual perforations – 2.9 times, residual cholesteatoma – 2.9
times, the number of repeated operations – 3.5 times relative to the
comparison group.
Conclusion: At the combined surgery of cholesteatoma otitis with
endoscopic support at patients of the main group the percent of residual
cholesteatoma is lower. The endoaural drainage of the antrum provides
additional ventilation and drainage of the reconstructed cavities of a
middle ear in the early postoperative period, increases the number of
primary engraftment of the neotympanic membrane and reduces the percentage
of residual perforations. |
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Keywords
middle ear microsurgery in children, endoscopic surgical procedures, middle
ear, cholesteatoma, tympanoplasty, anthrodrainage, adenotomy. |
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