Postoperative Outcome of Elective Mastoid Surgery: Pediatric versus Adult Patients
30 September 2019 (online)
Aim Analysis of postoperative outcome in elective mastoid surgeries in pediatric versus adult patients in terms of safe and dry ear, hearing restoration, cavity problems, and quality of life.
Materials and Methods In this cross-sectional study, all patients who underwent elective mastoid (primary and revision) surgery between 2011 and 2016 in a tertiary care hospital were recruited.
Results Forty-one pediatric and 59 adult postmastoidectomy patients were recruited. The mean duration of follow-up from the date of surgeries was 20 months in pediatric and 40 months in adult patients. 92.7% of pediatric and 96.6% of adult patients had safe ear at the time of evaluation. Seventy-three percent of pediatric and 80% of adult patients had dry ear and presence of granulation tissue was the most common cause for otorrhea in both the groups. Hearing improved by a mean of 16 dB in 63% of 27 pediatric patients and by 14 dB in 43% of 42 adult patients who underwent same stage tympanoplasty. Pediatric patients had a statistically significant better hearing outcome with major columella tympanoplasty as compared with adult patients. Also, 19.5% of pediatric and 40% of adult patients complained of tinnitus.
Conclusion Majority of pediatric patients with poor quality of life had otorrhea as compared with hearing impairment in adults. The incidence of high-facial ridge and sump effect was higher in pediatric patients. Pediatric patients had a better hearing outcome with major columella tympanoplasty than adult patients.
Clinical Significance Apart from complete disease clearance and tympanoplasty, adequate lowering of facial ridge, reducing the mastoid cavity size, and ensuring complete epithelialization of cavity in the postoperative period will improve the quality of life in pediatric patients undergoing mastoidectomy.