A HOSPITAL BASED STUDY ON CLINICAL INDICATIONS, PRESENTATIONS AND OPERATIVE FINDING OF MASTOIDECTOMY IN CHILDREN.

Dr. Mukul Patar, Dr. Taufeequl Islam, Prof. Kalpana Sharma, Dr. Abhilasha Goswami

Abstract


Objective: a) To evaluate indications and presentations of the children who underwent mastoidectomy procedures. b) To evaluate different operative findings of mastoidectomy in children.

Study Design: Retrospective study.

Materials: Data of all the mastoidectomy procedures done in children of 16 years of age and below, at Dept. of ENT, Gauhati Medical College & Hospital from 1st March 2018 to 28th February 2019 were taken into account. Data were collected on gender, age, ear affected, clinical presentations and indications for surgery, operative findings and recidivistic disease.

Results: A total of 30 patients between 7 to 16 years of age had undergone mastoidectomy procedures in Dept of ENT, Gauhati Medical College & Hospital, between 1st March 2018 and 28th February 2019. It is found that total 88 cases of mastoidectomy surgeries (both adult and children) were done during the above said period and  mastoidectomy in children in age group  up to <16 years constitutes 34.09% of total cases. Out of total 30 cases 12 cases (40%) had bilateral ear diseases, 14 cases (46.66%) had left ear and only 4 cases (13.33%) had right ear involvement. 3 cases (10%) clinically presented with post aural abscess and CSOM with aural polyp was present in 3 cases (10%). CSOM with cholesteatoma without intra-cranial complications was noted in 21 cases (70.00%) and all of them underwent modified radical mastoidectomy. CSOM with intracranial complications were present in three cases (10%), out of which 2 cases presented with cerebellar abscess and one case with right sigmoid sinus thrombosis. Data on operative procedures showed 3 cases (10%) of cortical mastoidectomy, modified radical mastoidectomy in 21 cases (70%), and radical mastoidectomy was done in 6 cases (20%). 

Conclusion:   In mastoid surgery each operation should be tailored to each patient depending on the indications, age, duration of symptom, anatomy and preoperative and intra-operative findings. The disagreement between canal wall down (CWD) and canal wall up (CWU) techniques in matoidectomy of children still exists. Limitation of our study is that it is retrospective and period of study is only one year. 


Keywords


Cholesteatoma, Mastoiditis, Children

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References


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