Two-Step Surgical Treatment for Chronic Otitis: Providing Rationale for Time Interval
Study Objective: To improve the outcomes of two-step surgical treatment for chronic suppurative otitis media (CSOM). Study Design: This was a clinical study. Materials and Methods: This clinical study included 68 patients who were admitted to the Federal State Budget-Funded Institution St. Petersburg Research Institute of Ear, Throat, Nose and Speech, Ministry of Health of Russia, between 2005 and 2011 to have repeat middle-ear surgery. All patients were divided into 3 subgroups, depending on the time interval between their first middle-ear procedure — surgical drainage — and current hospitalization: subgroup 1 (between 6 month and 1 year; n = 10), subgroup 2 (between 1 and 3 years; n = 11), and subgroup 3 (more than 3 years; n = 47). These patients had a preoperative ENT examination and repeat middle-ear surgery. Results: Satisfactory clinical and anatomical outcomes were observed in all patients from subgroup 1, in 91% of patients in subgroup 2, and in 85% of patients in subgroup 3. Long-term hearing improvement was seen in all examined patients from subgroup 1, in 80% of patients from subgroup 2, and only in 65.9% of patients from subgroup 3. Conclusion: In most patients with CSOM, tympanoplasty performed between 6 months and 1 year after the first step of treatment — surgical drainage — helps prevent complications and achieve good outcomes from surgical treatment.