Tobias Dombrowski

Tonsillotomie verursacht weniger indirekte Kosten als Tonsillektomie

Gudnadottir G et al. Indirect costs related to caregivers‘ absence from work after paediatric tonsil surgery. Eur Arch Otorhinolaryngol 2017; 275: 2629–2636. doi:10.1007/s00405–0174526–7 BEI KINDERN MIT SCHLAFBEZOGENEN ATEMWEGSOBSTRUKTIONEN DURCH VERGRößERTE RACHENMANDELN HAT DIE TONSILLOTOMIE DIE TONSILLEKTOMIE HEUTE WEITGEHEND ERSETZT. VORTEIL KöNNTE NEBEN GERINGERER SCHMERZEN UND KüRZERER REKONVALESZENZZEIT AUCH EINE REDUKTION INDIREKTER KOSTEN DURCH KüRZERE ARBEITSAUSFALLZEITEN DER ELTERN ODER BETREUER SEIN. DIES WURDE IM RAHMEN EINER SCHWEDISCHEN KOHORTENSTUDIE UNTERSUCHT.

Audiometric Results of Open Cavity Tympanomastoidectomy in Advanced Attic Cholesteatoma

In this retrospective study, we evaluated the audiometric results after using the retrograde mastoidectomy technique with open mastoid cavity for the removal of extended attic cholesteatomas. The described technique was used for cholesteatoma removal in 168 adult patients with an average follow-up time of 12 months. Due to cholesteatoma extension far into the mastoid, the disease was eradicated by the canal wall down (CWD) technique with the creation of an open mastoid cavity. Primary surgery was carried out in 47% of ears, with the remaining 53% representing revision surgery. In all cases, a classical CWD with an open mastoid cavity and partial obliteration with cartilage was created. A dry ear was achieved in 94% of cases. A postoperative air-bone gap ≤20 dB was achieved in 42.9% of the operated ears. 9.3% (n = 15) of the operated ears showed a postoperative air-bone gap >30 dB. Important factors leading to significantly better hearing restoration were an intact malleus, the use of alloplastic titanium prostheses and primary surgery. Although most cholesteatomas nowadays can be eradicated with the canal wall up technique, in far advanced cholesteatomas, the CWD technique can be applied with acceptable postoperative hearing results.