“Benefits of the pedicled osteoplastic flap as a surgical approach of mastoidectomy in cochlear implant surgery”

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorLOPES, P. T.
dc.contributor.authorBENTO, R. F.
dc.contributor.authorGEBRIM, E. M. Mello Santiago
dc.contributor.authorBECK, R. M. de Oliveira
dc.contributor.authorCARVALLO, R. Mota Memede
dc.contributor.authorSANCHES, S. G. Gandolfi
dc.contributor.authorLESSER, J. C. Cisneros
dc.date.accessioned2024-03-13T19:56:22Z
dc.date.available2024-03-13T19:56:22Z
dc.date.issued2022
dc.description.abstractObjective: To evaluate the esthetic and functional results of an osteoplastic flap for mastoid cavity closure in cochlear implant surgery. Study design: Double-blind, prospective, randomized clinical trial. Setting: tertiary referral center. Intervention(s): On hundred and twenty-six patients were randomized in 2 groups for cochlear implant surgery. Cases (n: 63) underwent simple mastoidectomy using an anteriorly pedicled osteoplastic flap for mastoid closure. In controls (n: 63), a traditional periosteal flap was used. Evaluation with the POSAS questionnaire was performed 1 year after surgery to assess surgical wound esthetics. Sixteen patients from each group had postoperative CT-scans and wideband tympanometry to assess mastoid aeration and middle ear absorbance. Gender and time after surgery were correlated. Main outcome measure(s): Evaluation of the quality of the surgical wound with the application of a questionnaire validated in the medical literature and translated into Portuguese language called POSAS, considering the perception of the blinded patient and doctor regarding the surgical technique proceeded. A lower POSAS score suggests better esthetics of the surgical wound. Secondary outcomes are volumetric measurement of aeration inside mastoid cavity using 3D computer tomography exam, which aims to analyze the influence of fibrocicatricial retraction in the surgical wound into the mastoid and the interference of its aeration volume in the absorption of sound in the middle ear, using the wideband tympanometry exam. Results: The POSAS questionnaire in the Case group showed a lower level of local pain and itchiness, a skin color and thickness more similar to the surrounding skin and less irregularity and stiffness, with no influence from time after surgery and gender compared to the Control group. The median tomographic volume was 6.37 cc in the cases and 4.60 cc in controls. Wideband tympanometry showed general smaller sound absorbance in the Case group results, specially, at 1000 Hz frequency. No intraoperative or postoperative complications were observed with the osteoplastic flap. Conclusions: This technique is an effective and safe alternative to alleviate common problems of mastoid surgery for cochlear implantation. In addition to esthetic benefits, it has less interference in middle ear physiology of sound absorbance and less fibrous tissue into the mastoid cavity during the follow-up of more than 1 year.eng
dc.description.indexMEDLINE
dc.description.indexPubMed
dc.description.indexScopus
dc.identifier.citationEUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY, v.279, n.5, p.2259-2268, 2022
dc.identifier.doi10.1007/s00405-021-06907-1
dc.identifier.issn0937-4477
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/58630
dc.language.isoeng
dc.publisherSPRINGER SCIENCE AND BUSINESS MEDIA DEUTSCHLAND GMBHeng
dc.relation.ispartofEuropean Archives of Oto-Rhino-laryngology
dc.rightsrestrictedAccesseng
dc.rights.holderCopyright SPRINGER SCIENCE AND BUSINESS MEDIA DEUTSCHLAND GMBHeng
dc.subjectAcoustic impedance testseng
dc.subjectCochlear implanteng
dc.subjectEstheticseng
dc.subjectMastoidectomyeng
dc.subjectSurgical flapeng
dc.subjectWound healingeng
dc.subject.othercholesteatoma, middle eareng
dc.subject.othercochlear implantationeng
dc.subject.othercochlear implantseng
dc.subject.otherhumanseng
dc.subject.othermastoideng
dc.subject.othermastoidectomyeng
dc.subject.otherprospective studieseng
dc.subject.otherretrospective studieseng
dc.subject.othersurgical woundeng
dc.subject.othertreatment outcomeeng
dc.subject.otheradulteng
dc.subject.otherarticleeng
dc.subject.otherclinical articleeng
dc.subject.othercomputer assisted tomographyeng
dc.subject.othercontrolled studyeng
dc.subject.otherdouble blind procedureeng
dc.subject.otherfemaleeng
dc.subject.otherhumaneng
dc.subject.othermaleeng
dc.subject.othermastoidectomyeng
dc.subject.otherosteoplastic flapeng
dc.subject.otheroutcome assessmenteng
dc.subject.otherrandomized controlled trialeng
dc.subject.othersurgical flapseng
dc.subject.othersurgical woundeng
dc.subject.othertympanometryeng
dc.subject.othervolumetryeng
dc.subject.othercholesteatomaeng
dc.subject.othercochlea prosthesiseng
dc.subject.othercochlear implantationeng
dc.subject.othermastoideng
dc.subject.othermastoidectomyeng
dc.subject.otherprocedureseng
dc.subject.otherprospective studyeng
dc.subject.otherretrospective studyeng
dc.subject.othersurgical woundeng
dc.subject.othertreatment outcomeeng
dc.title“Benefits of the pedicled osteoplastic flap as a surgical approach of mastoidectomy in cochlear implant surgery”eng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.affiliation.countryMéxico
hcfmusp.affiliation.countryisomx
hcfmusp.author.externalLESSER, J. C. Cisneros:Otorhinolaryngology Department, PhD, National Institute of Rehabilitation, Mexico City, Mexico
hcfmusp.citation.scopus1
hcfmusp.contributor.author-fmusphcPAULA TARDIM LOPES
hcfmusp.contributor.author-fmusphcRICARDO FERREIRA BENTO
hcfmusp.contributor.author-fmusphcELOISA MARIA MELLO SANTIAGO GEBRIM
hcfmusp.contributor.author-fmusphcROBERTO MIQUELINO DE OLIVEIRA BECK
hcfmusp.contributor.author-fmusphcRENATA MOTA MAMEDE CARVALLO
hcfmusp.contributor.author-fmusphcSEISSE GABRIELA GANDOLFI SANCHES
hcfmusp.description.beginpage2259
hcfmusp.description.endpage2268
hcfmusp.description.issue5
hcfmusp.description.volume279
hcfmusp.origemSCOPUS
hcfmusp.origem.dimensionspub.1138769313
hcfmusp.origem.pubmed34110455
hcfmusp.origem.scopus2-s2.0-85107461018
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hcfmusp.scopus.lastupdate2024-05-17
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