Managing Complex Chronic Otitis Media: Insights from Subtotal Petrosectomy with Blind Sac Closure

Objectives: Chronic otitis media poses a surgical challenge, and subtotal petrosectomy represents a last-resort intervention. This study aims to evaluate the efficacy and safety of subtotal petrosectomy with blind sac closure of the external auditory canal in managing chronic and recurrent otitis media by sharing our experiences and discussing the findings from a comprehensive literature review. Methods: A retrospective analysis including nine patients undergoing subtotal petrosectomy with blind sac closure of the external auditory canal was conducted. Additionally, two independent otolaryngologists conducted a review according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. The criteria for considering studies for the review were based on the population, intervention, comparison, outcome, timing, and setting (PICOTS) framework. Results: Our retrospective analysis comprised eight chronic cholesteatomatous otitis media cases and one atelectatic case. No postoperative complications occurred. The literature review discussed SP applications, surgical techniques, and outcomes from 17 selected studies. Conclusions: Subtotal petrosectomy with blind sac closure of the external auditory canal effectively manages chronic otitis, exhibiting minimal complications and improved postoperative outcomes. Despite study limitations, including a small sample size, this research provides valuable insights into subtotal petrosectomy's application and success. The literature review enhances understanding by summarizing findings from diverse studies, offering a comprehensive view of the procedure's evolution and applications.