Subtotal petrosectomy: Long term surgical results in managing chronic ear disease

Abstract

Objectives: To investigate the long term surgical results of subtotal petrosectomy, a retrospective study of the patients with chronic otitis media who underwent subtotal petrosectomy with or without cochlear implantation was performed. Subjects & Methods: Twenty nine patients (14 men and 15 women, mean age 61.5 years, SD 8.7 year) who received subtotal petrosectomy by one surgeon between April 2004 and December 2015 were included in this study. Ten patients underwent simultaneous or sequential cochlear implantation for the hearing rehabilitation depending on the active inflammatory condition of their middle ear. In all cases, after complete eradication of the pathology, mastoid cavity was obliterated with abdominal fat followed by double layered external auditory canal obliteration with special cosmetic concern. Surgical outcomes of this procedure were analyzed. Results: Middle ear inflammation and cholesteatoma were completely managed with this surgical technique. None of the patients showed the inflammatory symptoms of otorrhea or other early inflammatory complication after the surgery. Cochlear implant was successfully placed and active electrodes were fully inserted in all of the 10 patients. Only one patient showed the delayed extrusion of the ball electrode to the obliterated ear canal which was successfully managed by replacement of extruded ball electrode with conchal cartilage reinforcement under local anesthesia. Postoperative quality of life during the medical interview revealed the highly satisfied status of subtotal petrosectomy from both disease eradication and cosmetic viewpoints. Conclusion: Subtotal petrosectomy seems to be very safe, effective and even cosmetically acceptable procedure for the deafened patients with chronic otitis media whether accompanying cochlear implantation is planned or not.