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  • Title: Tympanomastoidectomy: planned second-look tympanotomy.
    Author: Dawes PJ, Al-Qudah M.
    Journal: J Otolaryngol Head Neck Surg; 2009 Jun; 38(3):311-7. PubMed ID: 19476762.
    Abstract:
    OBJECTIVE: To review the outcome following surgery for cholesteatoma/retraction pocket disease where second-look tympanotomy was recommended for selected patients. DESIGN: Retrospective outcome analysis following canal wall down mastoid surgery for cholesteatoma/retraction pocket disease. SUBJECTS: The study included 158 patients (163 ears) operated on between 1993 and 2003. Data were collected on the recommendation for second-look tympanotomy, the findings at second-look tympanotomy, and hearing threshold. RESULTS: Second-look tympanotomy was recommended for 36 patients, 32 had surgery, and 30 were free of residual disease. The respective mean pre- and postoperative bone conduction threshold was 8.9 dB and 18 dB for single-stage surgery and 15.8 dB and 16.8 dB for second-look tympanotomy. The mean preoperative air-bone gap (0.5, 1, 2, 4 kHz) was 27.1 dB for single-stage surgery and 27.9 dB for staged surgery. The 1-year air-bone gap was 24.6 dB and 28.6 dB, respectively. CONCLUSION: Planned second-look tympanotomy demonstrated excellent early disease control and allowed management of the middle ear pathology.
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