Middle ear atelectasis (MEA) is one of the ailments that can remarkably affect the quality of life of patients. Surgical management of MEA can also carry a lot of morbidity issues.
In our study, we were looking for a method to modify the condition of the middle ear prior to surgery in a way that minimizes the extent of the surgical procedure needed to treat MEA. The impact of this minimization on the morbidities associating such procedures was studied.
A prospective, case-control study was conducted on 82 cases of MEA with comparable depth of skeletonization of the ossicles. Pre-procedural CT scan was done to exclude cholesteatoma, audiologic evaluation for base-line recording, as well as endoscopic examination. T-tube insertion was done in 41 cases (group 1). Group 2 included 41 cases that were followed up. The 82 cases were followed up bi-annually for two years. The follow up included endoscopic examination, audiometry and tympanometry.
14 cases of group 2 (34%) developed cholesteatoma and required modified radical surgeries, compared to 1 case of group 2 (2.4%) . 27 cases of group 2 (66%) had progressive adhesions with development of retraction pockets compared to 2 cases of group 1 (4.8%). 31 cases of group 1 (75.6%) showed progressive improvement of the ME condition reflected on the regression of the depth of skeletonization, with no more MEA but with thin tympanic membrane (TM) compared to zero cases (0%) of group 2. These 31 cases needed further cartilage grafting to re-enforce the TM. 7 cases of group 1 (17%) had completely healthy TM, and therefore required no further management, again compared to zero cases of group 2 (0%). The results showed statistically significant difference between the 2 groups.