Section: 
Otiology
OtiologyPostoperative treatment of patients after canal wall down mastoidectomy
F. V. Semenov (1), V. S. Untevskii (2)
(1), (2) Kuban State Medical University, Krasnodar, 350063, Russian Federation
UDK: УДК 616.288.5-089.168.1
DOI: https://doi.org/10.18692/1810-4800-2025-2-81-89
ABSTRACT
Abstract. Introduction. Middle ear surgery with removal of the posterior wall of the auditory canal leads to the formation of a large trepanation cavity. Its healing goes through all phases of the wound process with the anatomical and physiological features inherent in this area. The final result of treatment depends on the completeness and speed of epithelialization of the wound surface. Wound coverings have proven themselves as a reliable method of postoperative care, but in otology the experience of their use is rather scarce. Objective. To study the effectiveness of differentiated use of wound coverings at different stages of the wound process after canal wall down surgery on the middle ear. Methods. A prospective controlled study included 85 patients after canal wall down surgery on the middle ear. Subjective and objective clinical and morphological indicators of the course of the wound process were assessed. The observation period was 60 days. Results. From the 14th day of observation, patients in the wound coverings group scored 21 ± 4.13 points on the Chronic Otitis Media Questionnaire (COMQ-12) instead of 25 ± 4.24 in the control group (p = 0.001). The otoscopic picture was different from the 7th day of the study (p = 0.039). Complete epithelialization in the wound coverings group was observed from the 21st day in 9 patients (16.36%), and by the end of the study it was achieved in 53 people (96.3%) (p < 0.001). The content of proinflammatory cytokines IL-8 and IL-17 in ear washes significantly decreased with the use of wound coverings. IL-8 decreased from 1,192.24 ± 464.76 pg/mL at the beginning of the study to 770.65 ± 300.78 pg/mL by day 30 (p = 0.011), and IL-17 decreased from 21.85 ± 4.9 pg/mL to 11.96 ± 2.24 pg/mL (p < 0.001). On the 21st day, in the imprint smears in the main group, the inflammatory-regenerative type of cytogram was detected in 61.8% of cases, and the regenerative type, in 36.4%, which differed from the results in the comparison group (p = 0.017) where the inflammatory type was found with a frequency of 36.7%; inflammatory-regenerative, in 33.3%; and regenerative, in 30%. Practical significance. Wound coverings have proven to be an effective method of postoperative treatment of trepanation cavities of the middle ear and are recommended for use in clinical practice.
Publication date:
21.04.2025
Keywords:
wound process, wound coverings, healing, postoperative treatment, middle ear, quality of life For citation:
Semenov F. V., Untevskii V. S. Postoperative treatment of patients after canal wall down mastoidectomy. Russian Otorhinolaryngology. 2025;24(2):81-89. (In Russ.) https://doi.org/10.18692/1810-4800-2025-2-81-89