Subtotal petrosectomy for the treatment of cholesteatoma. Retrospective study in uhd 2008-2018

Abstract

Cholesteatoma is a collection of keratinized squamous epithelium of varied origin that grows in the middle ear, capable to produce different clinics depending on its location and size. Its treatment is eminently surgical, being tympanoplasty or mastoidectomy the techniques of choice. Sometimes, however, more invasive techniques such as subtotal petrosectomy (STP) are necessary. This work analyzed the results of the STP performed at the University Hospital of Donostia (UHD) between 2008 and 2018 with the indication of chronic otitis media or cholesteatoma and then compared them with the results found in the literature. The data of the STP carried out between 2008 and 2018 at the UHD otolaryngology service were collected in order to later select those that had chronic otitis media or cholesteatoma as an indication and different parameters were analyzed. In addition, a literature search was performed in Pubmed's database on the STP and the results were compared with those of UHD. Between 2008 and 2018, 73 PSTs were performed, being the most frequent indications chronic otitis media (31%), cholesteatoma recurrence (25%) and tumour processes (29%). From all the PST, 35 were indicated in the context of chronic otitis media or cholesteatoma. The average hospital stay was 5.74 days. Average post-surgical follow-up was 3.45 years, using nuclear magnetic resonance (MRI) for control in 48.6% of cases. The most frequent complications were: infection, facial paralysis, vestibular hypofunction, bleeding, atrial fistula, and recurrence of cholesteatoma. In general, the results of UHD coincide with those found in the literature regarding indications, preoperative situation, type of patient and audiological situation. Regarding complications, they have also appeared in similar proportion, being the infection rate higher in the UHD series, for which we recommend a more directed study.