Flexible approach to tympanomastoidectomy
| Autor: | Oleg Fromovich, Barry P. Kimberley |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
medicine.medical_specialty
Tympanic Membrane medicine.medical_treatment Mastoid Acute illness Medicine Humans Intensive care medicine Surgical approach business.industry Otitis Media with Effusion Optimal treatment General Medicine Tympanoplasty Plastic Surgery Procedures medicine.disease Surgery Otitis medicine.anatomical_structure Otorhinolaryngology Surgical Procedures Operative Middle ear Sensorineural hearing loss Tympanomastoidectomy medicine.symptom business |
| Zdroj: | Otolaryngologic clinics of North America. 32(3) |
| ISSN: | 0030-6665 |
| Popis: | The characterization of patients with chronic, recurring otitis media (OM) encompasses a wide variety of underlying pathologic conditions and clinical presentations. For example, children who have recurrent acute otitis media but whose middle ears clear in between individual bouts of acute illness likely have a different underlying pathologic finding and optimal treatment options from those of individuals who have chronically draining ears and perhaps sensorineural hearing loss induced by OM. Between these two extremes are many other variations, both of underlying pathologic conditions and of appropriate surgical responses. Intervention varies from prophylactic antibiotics to placement of ventilation tubes to tympanoplasty with reconstruction of the middle ear and, ultimately, open-cavity mastoid surgery. This article provides some guidance in the appropriate choice of intervention based on assumptions about underlying pathologic tissues and anatomy. This variable surgical approach to chronic otitis media (COM) has been termed “the flexible surgical approach for treating OM.” Three important general considerations have been observed in previous studies of the pathogenesis of OM. They are that (1) a continuum (including overlap of types) of OM, including silent otitis media, exists; (2) pathologic conditions and the location of the pathologic condition (i.e., localized or generalized) may vary; and (3) often, pathologic and anatomic narrowings or obstructive sites exist along the middle ear cleft. Understanding these principles allows surgeons to customize the operation to correct the problems present and to help prevent future sequelae. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|