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Unique microbiology of chronically unstable canal wall down tympanomastoid cavities: considerations for surgical revision

Published online by Cambridge University Press:  03 April 2013

M B Gluth ,
B Y B Tan ,
P L Santa Maria  and
M D Atlas
M B Gluth*
Affiliation:
Department of Otolaryngology - Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, USA Ear Science Institute Australia and Ear Sciences Centre, University of Western Australia, Perth, Australia
B Y B Tan
Affiliation:
Department of Otolaryngology, Singapore General Hospital, Singapore Ear Science Institute Australia and Ear Sciences Centre, University of Western Australia, Perth, Australia
P L Santa Maria
Affiliation:
Ear Science Institute Australia and Ear Sciences Centre, University of Western Australia, Perth, Australia
M D Atlas
Affiliation:
Ear Science Institute Australia and Ear Sciences Centre, University of Western Australia, Perth, Australia
*
Address for correspondence: Dr M B Gluth, Department of Otolaryngology – Head and Neck Surgery, University of Arkansas for Medical Sciences, 4301 W. Markham St., 543, Little Rock, Arkansas 72205, USA Fax: +1 501 686 8029 E-mail: [email protected]
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Abstract

Objective:

To review the microbiology of open tympanomastoid cavities in patients who underwent revision surgery due to chronic instability.

Methods:

This paper describes a retrospective chart review of surgical revision cases of chronically unstable open mastoid cavities. Patient records from 2000 to 2010 were reviewed for the type of organism cultured, antimicrobial resistance and the presence of cholesteatoma.

Results:

In total, 121 revision surgical procedures were performed on 101 patients. Seventy-nine procedures involved culture specimen processing, 37 of which were positive. The most commonly cultured organism was Staphylococcus aureus, which was more than twice as common as any other pathogen. The presence of cholesteatoma had no impact on the likelihood of a positive culture or polymicrobial culture. Antimicrobial-resistant pathogens were uncommon.

Conclusion:

A positive culture was not an overwhelmingly common characteristic of unstable tympanomastoid cavities. Furthermore, antimicrobial resistance did not appear to play an essential role in leading patients towards revision open mastoid surgery.

Keywords

MastoidectomyCholesteatomaOtitis Media
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 5 , May 2013 , pp. 458 - 462
Copyright
Copyright © JLO (1984) Limited 2013 

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Footnotes

Presented orally at the Australian Society of Otolaryngology – Head and Neck Surgery annual scientific meeting, 31 March – 4 April 2012, Adelaide, Australia.

References

1Dornhoffer, JL, Smith, J, Richter, G, Boeckmann, J. Impact on quality of life after mastoid obliteration. Laryngoscope 2008;118:1427–32CrossRefGoogle ScholarPubMed
2Males, AG, Gray, RF. Mastoid misery: quantifying the distress in a radical cavity. Clin Otolaryngol Allied Sci 1991;16:12–14CrossRefGoogle Scholar
3Gluth, MB, Metrailer, AM, Dornhoffer, JL, Moore, PE. Patterns of failure in canal wall down mastoidectomy cavity instability. Otol Neurotol 2012;33:998–1001CrossRefGoogle ScholarPubMed
4Sade, J, Weinberg, J, Berco, E, Brown, M, Halevy, A. The marsupialized (radical) mastoid. J Laryngol Otol 1982;96:869–75CrossRefGoogle ScholarPubMed
5Choi, HG, Park, KH, Park, SN, Jun, BC, Lee, DH, Yeo, SW. The appropriate medical management of methicillin-resistant Staphylococcus aureus in chronic suppurative otitis media. Acta Otolaryngol 2010;130:42–6CrossRefGoogle ScholarPubMed
6Erkan, M, Aslan, T, Sevuk, E, Guney, E. Bacteriology of chronic suppurative otitis media. Ann Otol Rhinol Laryngol 1994;103:771–4CrossRefGoogle ScholarPubMed
7Fliss, DM, Dagan, R, Meidan, N, Leiberman, A. Aerobic bacteriology of chronic suppurative otitis media without cholesteatoma in children. Ann Otol Rhinol Laryngol 1992;101:866–9CrossRefGoogle ScholarPubMed
8Indudharan, R, Haq, JA, Aiyar, S. Antibiotics in chronic suppurative otitis media: a bacteriologic study. Ann Otol Rhinol Laryngol 1999;108:440–5CrossRefGoogle ScholarPubMed
9Kenna, MA, Bluestone, CD. Microbiology of chronic suppurative otitis media in children. Pediatr Infect Dis 1986;5:223–5CrossRefGoogle ScholarPubMed
10Khanna, V, Chander, J, Nagarkar, NM, Dass, A. Clinicomicrobiologic evaluation of active tubotympanic type chronic suppurative otitis media. J Otolaryngol 2000;29:148–53Google ScholarPubMed
11Papastavros, T, Giamarellou, H, Varlejides, S. Role of aerobic and anaerobic microorganisms in chronic suppurative otitis media. Laryngoscope 1986;96:438–42CrossRefGoogle ScholarPubMed
12Yeo, SG, Park, DC, Hong, SM, Cha, CI, Kim, MG. Bacteriology of chronic suppurative otitis media–a multicenter study. Acta Otolaryngol 2007;127:1062–7CrossRefGoogle ScholarPubMed
13Merchant, SN, Wang, P, Jang, CH, Glynn, RJ, Rauch, SD, McKenna, MJ et al. Efficacy of tympanomastoid surgery for control of infection in active chronic otitis media. Laryngoscope 1997;107:872–7CrossRefGoogle ScholarPubMed
14Verhoeff, M, van der Veen, EL, Rovers, MM, Sanders, EA, Schilder, AG. Chronic suppurative otitis media: a review. Int J Pediatr Otorhinolaryngol 2006;70:1–12CrossRefGoogle ScholarPubMed
15Brook, I, Yocum, P. Quantitative bacterial cultures and beta-lactamase activity in chronic suppurative otitis media. Ann Otol Rhinol Laryngol 1989;98:293–7CrossRefGoogle ScholarPubMed
16Jonsson, L, Schwan, A, Thomander, L, Fabian, P. Aerobic and anaerobic bacteria in chronic suppurative otitis media. A quantitative study. Acta Otolaryngol 1986;102:410–14CrossRefGoogle ScholarPubMed
17Albert, RR, Job, A, Kuruvilla, G, Joseph, R, Brahmadathan, KN, John, A. Outcome of bacterial culture from mastoid granulations: is it relevant in chronic ear disease? J Laryngol Otol 2005;119:774–8CrossRefGoogle ScholarPubMed
18Wormald, PJ, Nilssen, EL. The facial ridge and the discharging mastoid cavity. Laryngoscope 1998;108:92–6CrossRefGoogle ScholarPubMed
19Wormald, PJ, van Hasselt, CA. A technique of mastoidectomy and meatoplasty that minimizes factors associated with a discharging mastoid cavity. Laryngoscope 1999;109:478–82CrossRefGoogle ScholarPubMed
20Bakaletz, LO. Bacterial biofilms in otitis media: evidence and relevance. Pediatr Infect Dis J 2007;26(suppl 10):S17–19CrossRefGoogle ScholarPubMed
21Lee, MR, Pawlowski, KS, Luong, A, Furze, AD, Roland, PS. Biofilm presence in humans with chronic suppurative otitis media. Otolaryngol Head Neck Surg 2009;141:567–71CrossRefGoogle ScholarPubMed
22Youngs, R. Temporal bone histopathology of open mastoidectomy cavities. J Laryngol Otol 1993;107:569–73CrossRefGoogle ScholarPubMed
23Youngs, R. The histopathology of mastoidectomy cavities, with particular reference to persistent disease leading to chronic otorrhoea. Clin Otolaryngol Allied Sci 1992;17:505–10CrossRefGoogle ScholarPubMed
24Dornhoffer, JL. Surgical modification of the difficult mastoid cavity. Otolaryngol Head Neck Surg 1999;120:361–7CrossRefGoogle ScholarPubMed
25Ramsey, MJ, Merchant, SN, McKenna, MJ. Postauricular periosteal-pericranial flap for mastoid obliteration and canal wall down tympanomastoidectomy. Otol Neurotol 2004;25:873–8CrossRefGoogle ScholarPubMed
26Singh, V, Atlas, M. Obliteration of the persistently discharging mastoid cavity using the middle temporal artery flap. Otolaryngol Head Neck Surg 2007;137:433–8CrossRefGoogle ScholarPubMed
27Hung, T, Leung, N, van Hasselt, CA, Liu, KC, Tong, M. Long-term outcome of the Hong Kong vascularized, pedicled temporalis fascia flap in reconstruction of mastoid cavity. Laryngoscope 2007;117:1403–7CrossRefGoogle Scholar