VAI TRÒ CỦA PHẪU THUẬT XƯƠNG CHŨM TRONG ĐIỀU TRỊ VIÊM TAI GIỮA MẠN TÍNH KHÔNG NGUY HIỂM: MỘT NGHIÊN CỨU TỔNG QUAN

Abstract

Objective: Study the role of simple mastoidectomy in treatment of tubotympanic chronic otitis media. Study design: Scoping review. Method: A systematic search was conducted using the PubMed, Cochrane databases up to June 2022. The literature was screened on mastoidectomy in treatment of tubotympanic chronic otitis media, examining the success of tympanic membrane repair and indication of mastoidectomy. Result: Twenty articles were reviewed examining surgical outcomes for patients with tubotympanic chronic otitis media. There was 8 prospective randomized trials (RCT), 10 retrospective studies and 2 case-series. There are 17 studies comparing outcome of tympanomastoidectomy and tympanoplasty alone, in which 94% has P-value>0,05. 45% of the studies are agree with mastoidectomy indication for chronic otitis media mucosal type, there are 1 RCT with level of evidence grade 2b and 8 study grade 4. 55% of the studies are not agree with mastoidectomy for indication, in which, there are 7 RCTs grade 1b and 4 grade 4 studies. Conclusion: Concomitant mastoidectomy for tubotympanic chronic otitis media does improve outcome of tympanoplasty. Mastoidectomy is maybe helpful cases of unhealthy midle ear mucosa, MRSA infected chronic otitis media and hidden formation in the mastoid. Consider risk, cost and value when indicate mastoidectomy for tubotympanic chronic suppurative otitis media.