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The role of mastoidectomy in outcomes following tympanic membrane repair: a review.

Publication ,  Journal Article
Eliades, SJ; Limb, CJ
Published in: Laryngoscope
July 2013

OBJECTIVES/HYPOTHESIS: The role of mastoidectomy performed with tympanoplasty for tympanic membrane perforations in the absence of cholesteatoma remains controversial. Some authorities suggest that outcomes are improved by the pressure buffering contributed by a well-aerated mastoid. It is unclear, however, whether or not clinical evidence demonstrates a benefit by the addition of a mastoidectomy. STUDY DESIGN: Review of peer-reviewed publications. METHODS: The literature on tympanoplasty and mastoidectomy was reviewed, examining the success of tympanic membrane repair, control of drainage, and hearing improvement. RESULTS: Twenty-six articles were reviewed examining surgical outcomes for patients with perforations resulting from chronic suppurative otitis media without cholesteatoma. Most of the literature consisted of retrospective cohort studies and case series with only a few small prospective randomized trials. Retrospective studies were commonly biased by performing mastoidectomy in ears with worse disease, and methodological differences made comparisons between studies difficult to interpret. There was no evidence of improved outcomes following mastoidectomy compared to tympanoplasty alone. Subgroup analysis, including actively discharging ears, extensive mucosal inflammation, large or repeat perforations, or sclerotic mastoids had overall worse outcomes. These patients showed a nonsignificant trend toward slightly improved results with mastoidectomy. CONCLUSIONS: The available literature shows no additional benefit to performing mastoidectomy with tympanoplasty for uncomplicated tympanic membrane perforations. Patients with more complicated disease may benefit from the addition of a mastoidectomy, but there is insufficient evidence to make a recommendation for this population. Further prospective controlled studies are needed.

Duke Scholars

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Published In

Laryngoscope

DOI

EISSN

1531-4995

Publication Date

July 2013

Volume

123

Issue

7

Start / End Page

1787 / 1802

Location

United States

Related Subject Headings

  • Tympanoplasty
  • Tympanic Membrane Perforation
  • Tympanic Membrane
  • Outcome and Process Assessment, Health Care
  • Otorhinolaryngology
  • Mastoid
  • Humans
  • 3202 Clinical sciences
  • 1103 Clinical Sciences
 

Citation

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Eliades, S. J., & Limb, C. J. (2013). The role of mastoidectomy in outcomes following tympanic membrane repair: a review. Laryngoscope, 123(7), 1787–1802. https://doi.org/10.1002/lary.23752
Eliades, Steven J., and Charles J. Limb. “The role of mastoidectomy in outcomes following tympanic membrane repair: a review.Laryngoscope 123, no. 7 (July 2013): 1787–1802. https://doi.org/10.1002/lary.23752.
Eliades SJ, Limb CJ. The role of mastoidectomy in outcomes following tympanic membrane repair: a review. Laryngoscope. 2013 Jul;123(7):1787–802.
Eliades, Steven J., and Charles J. Limb. “The role of mastoidectomy in outcomes following tympanic membrane repair: a review.Laryngoscope, vol. 123, no. 7, July 2013, pp. 1787–802. Pubmed, doi:10.1002/lary.23752.
Eliades SJ, Limb CJ. The role of mastoidectomy in outcomes following tympanic membrane repair: a review. Laryngoscope. 2013 Jul;123(7):1787–1802.
Journal cover image

Published In

Laryngoscope

DOI

EISSN

1531-4995

Publication Date

July 2013

Volume

123

Issue

7

Start / End Page

1787 / 1802

Location

United States

Related Subject Headings

  • Tympanoplasty
  • Tympanic Membrane Perforation
  • Tympanic Membrane
  • Outcome and Process Assessment, Health Care
  • Otorhinolaryngology
  • Mastoid
  • Humans
  • 3202 Clinical sciences
  • 1103 Clinical Sciences