1. Modified Bondy's technique: refinements of the surgical technique and long-term results.
- Author
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Sanna M, Facharzt AA, Russo A, Lauda L, Pasanisi E, and Bacciu A
- Subjects
- Audiometry, Audiometry, Pure-Tone, Cartilage, Articular surgery, Facial Muscles surgery, Female, Fistula pathology, Follow-Up Studies, Hearing Tests, Humans, Male, Preoperative Care, Retrospective Studies, Semicircular Canals pathology, Turbinates surgery, Cholesteatoma, Middle Ear surgery, Mastoiditis surgery, Tympanoplasty methods
- Abstract
Objective: To evaluate the short- (6 mo) and long-term (5 yr) outcomes of modified Bondy technique, with particular reference to hearing results., Study Design: Retrospective study., Setting: Quaternary referral otology and cranial base center., Patients: Two hundred thirty ears of 222 patients were operated on, using a modified Bondy technique between 1983 and 2005. All patients had primary acquired epitympanic cholesteatomas with intact pars tensa and intact ossicular chain in normal or good-hearing ear. Preoperative audiometric results revealed a mean air conduction pure-tone average of 27.7 +/- 9.6 dB (range, 10-65 dB) and a mean bone conduction pure-tone average of 14.2 +/- 6.4 dB (range, 5-50 dB). The mean preoperative air-bone gap was 13.5 +/- 6.7 dB (range, 0-25 dB). The average length of follow-up was 7.8 years (range, 5-16 yr)., Results: There was no recurrent cholesteatoma in the present series. A pearl-like residual cholesteatoma was found in the cavity in 7.4% of ears. Two patients (0.8%) developed stenosis of meatoplasty. Three ears (1.3%) exhibited retraction pockets extending to the attic. Postoperative discharging ear was observed in 3% of cases and was successfully treated with topical drops. At the long-term follow-up, the air-bone gap was unchanged or improved from the preoperative level in 88% of cases. The mean postoperative short- and long-term air-bone gaps were 14.6 +/- 8.5 dB (range, 0-55 dB) and 14.1 +/- 8.2 dB (range, 0-50 dB), respectively. Postoperative high-frequency sensorineural hearing loss with bone conduction worsening between 20 and 30 dB at 4 kHz was observed in 4 cases (1.7%). No dead ears were encountered postoperatively., Conclusion: A modified Bondy operation is recommended in selected cases of epitympanic cholesteatoma in normal or good-hearing ear with an intact pars tensa and ossicular chain. Modified Bondy technique ensures complete eradication of disease while preserving a good preoperative hearing in 1-stage operation.
- Published
- 2009
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