Objective: To study and evaluate a surgical option for the treatment of otitis media and mastoiditis with cholesteatoma and/or granulation tissue.
Methods: The procedure is called intact-bridge tympanomastoidectomy (IBM). There are some modifications for the treatment of patients suffered from chronic otitis media and mastoiditis with cholesteatoma and/or granulation tissue. The features of IBM include: 1. the aditus, mastoid and attic opened and the intractable pathological tissues eradicated thoroughly. 2. the posterior tympanal space opened through the facial recess if necessary. 3. a widened middle ear space by lowering bony bridge established. 4. the adults blocked. 5. immediate or staging tympanoplasties conducted according to the conditions of mucosa in the tympanum.
Results: The modified IBM procedure was performed on 62 ears from 61 cases. The follow-up has been 12-38 months and more than two years in 51 ears. The dry ear was obtained within 5-13 weeks with an average of 6 weeks. In 24.2% of ears the air-bone gap(ABG) was 20dB HL or less and within 21-30 dB HL in 41.9% of ears, the ABG over 31 dB HL was 16.1%.
Conclusion: Our results indicate that IBM procedure fulfills the desired purposes of both open- and close-cavity techniques, the thorough eradication of diseased tissue allow to get a dry ear and restoration of hearing. IBM, therefore, is a reasonable choice for the surgery of otitis media and mastoiditis with cholesteatoma and/or granulation tissue.