Petrosektomia subtotala kolesteatomaren tratamendurako: 2008-2018 arteko ikerketa erretrospektiboa duo-n

• Alonso Saenz del Burgo, Maitane ^[1]
  1. [1] EHUko Donostiako Medikuntza Ikastegia
• Localización: Osagaiz: osasun-zientzien aldizkaria, ISSN-e 2530-9412, Vol. 5, Nº. 1 (Ekaina), 2021, págs. 107-122
• Idioma: euskera
• Títulos paralelos:
  • Subtotal petrosectomy for the treatment of cholesteatoma. Retrospective study in uhd 2008-2018
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  • English

    Cholesteatoma is a collection of keratinized squamous epithelium of varied origin that grows in the middle ear, capable to produce different clinics depending on its location and size. Its treatment is eminently surgical, being tympanoplasty or mastoidectomy the techniques of choice. Sometimes, however, more invasive techniques such as subtotal petrosectomy (STP) are necessary. This work analyzed the results of the STP performed at the University Hospital of Donostia (UHD) between 2008 and 2018 with the indication of chronic otitis media or cholesteatoma and then compared them with the results found in the literature. The data of the STP carried out between 2008 and 2018 at the UHD otolaryngology service were collected in order to later select those that had chronic otitis media or cholesteatoma as an indication and different parameters were analyzed. In addition, a literature search was performed in Pubmed's database on the STP and the results were compared with those of UHD. Between 2008 and 2018, 73 PSTs were performed, being the most frequent indications chronic otitis media (31%), cholesteatoma recurrence (25%) and tumour processes (29%). From all the PST, 35 were indicated in the context of chronic otitis media or cholesteatoma. The average hospital stay was 5.74 days. Average post-surgical follow-up was 3.45 years, using nuclear magnetic resonance (MRI) for control in 48.6% of cases. The most frequent complications were: infection, facial paralysis, vestibular hypofunction, bleeding, atrial fistula, and recurrence of cholesteatoma. In general, the results of UHD coincide with those found in the literature regarding indications, preoperative situation, type of patient and audiological situation. Regarding complications, they have also appeared in similar proportion, being the infection rate higher in the UHD series, for which we recommend a more directed study.

  • euskara

    Kolesteatoma jatorri ezberdineko erdiko belarrian hazten den epitelio ezkatatsu keratinizatuaren bilduma da, tamaina eta kokapenaren arabera klinika zabala eman dezakeena. Kolesteatomaren tratamendua kirurgikoa da, eta tinpanoplastia edota mastoidektomia dira aukerako teknikak. Zenbaitetan, ordea, aukera inbasiboagoetara jo behar da, eta horrelakoetan petrosektomia subtotala (PST) aukera baliagarria bilaka daiteke. Lan honetan Donostia Unibertsitate Ospitalean (DUOn) 2008-2018 artean erdik obelarriko otitis kronikoaren edota kolesteatomaren tratamendurako egindako petrosektomia subtotalen emaitzak erretrospektiboki aztertu eta literaturan aurkitu diren emaitzekin alderatuko dira. DUOko Otorrinolaringologia Sailean 2008-2018 artean egin ziren PSTen datuak bildu eta indikazioa erdiko otitis kronikoa edota kolesteatoma ziren kasuak aztertu dira, parámetro ezberdinak ikertuz. Bestalde, PubMed datubasean PSTaren inguruko bilaketa bibliografikoa egin da eta DUOko emaitzak PubMed-en aurkitutakoekin alderatu dira. 2008-2018 artean 73 PST egin ziren, indikazio ohikoenak erdiko belarriko otitis kronikoa (% 31), kolesteatomaren errezidiba (% 25) eta prozesu tumoralak (% 29) izanik. PST guztietatik, 35ek izan zuten erdiko otitis kronikoa edota kolesteatoma indikazio gisa. Ospitaleko batez besteko egonaldia 5,74 egunekoa izan zen. Kirurgia ostean batez besteko jarraipen-denbora 3,45 urte izan zen, eta kontrolerako EMNa erabili zen kasuen % 48,6an. Maizen agertu ziren konplikazioak honakoak izan ziren: infekzioa, paralisifaziala, hipofuntzio bestibularra, odoljarioa, belarriko fistula eta kolesteatomaren errezidiba. Oro har, DUOko egoera literaturan aurkitutako egoeraren parekoa da indikazioen, kirurgiaaurreko egoeraren, paziente motaren eta egoera audiologikoaren ikuspuntutik. Konplikazioei dagokienez, antzeko portzentajean agertu dira, baina infekzio-tasa handiagoa aurkitu da DUOko seriean, eta, horregatik, ikerketa sakonago bat egin liteke.