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Is simultaneous bilateral mastoidectomy ever advisable?
J J Klemens1, E Mhoon, M Redleaf
1Section of Otolaryngology, Department of Surgery, University of Chicago, Chicago, Illinois, USA.
The Journal of Laryngology and Otology
|February 27, 2007
Summary
Bilateral, simultaneous tympanomastoidectomies (BST) offer potential patient benefits despite theoretical risks. Mathematical analysis shows a low risk of bilateral sensorineural hearing loss, suggesting BST can be safe.
Area of Science:
- Otolaryngology
- Surgical Procedures
Background:
- Experience with bilateral, simultaneous tympanomastoidectomies (BST) is reported.
- An opinion survey of otologists was conducted regarding BST.
Purpose of the Study:
- To evaluate the safety and outcomes of BST.
- To gauge otologists' opinions on BST.
Main Methods:
- Chart review of 12 patients undergoing BST.
- Opinion survey of 121 otologists.
Main Results:
- No adverse outcomes in BST patients that staging would have prevented.
- 23 of 24 operated ears maintained or improved hearing post-operatively.
- 74% of surveyed otologists deemed BST unsafe due to hearing loss risk.
Conclusions:
- The mathematical risk of bilateral sensorineural hearing loss from BST is low (0.006-0.2%).
- Otologists showed ambivalence, opposing BST theoretically but indicating its use.
- A decision tree for proceeding with BST is presented.
