Efficacy of tympanoplasty without mastoidectomy on MRSA-infected chronic otitis media

Otol Neurotol. 2014 Jul;35(6):976-80. doi: 10.1097/MAO.0000000000000296.

Abstract

Objectives/hypothesis: The prevalence of methicillin-resistant Staphylococcus aureus (MRSA)-infected chronic otitis media (COM) has been increasing, but to date, there has been no consensus on surgical treatment. Although there is a report that mastoidectomy is essential in treating MRSA-infected COM, in our experience, we found that tympanoplasty without mastoidectomy was sufficient. In this study, we evaluated the efficacy of tympanoplasty without mastoidectomy on MRSA-infected COM.

Study design: Retrospective case-control study.

Methods: Forty ears with MRSA-infected COM that underwent tympanoplasty without mastoidectomy were identified at a tertiary referral center from February 2006 to September 2011. Each case had two controls matched. Hearing results and postoperative complication were examined to evaluate the efficacy of tympanoplasty. The preoperative and postoperative pure tone audiometry was checked.

Results: In the MRSA group and control group, 5 out of 40 ears (12.5%) and 8 out of 80 ears (10%) showed postoperative complications, respectively. The hearing success rate was 95.8% (23/24) in the MRSA group and 91.7% (44/48) in the control group. In the MRSA group, the average air-bone gap was 20 dB preoperatively, and it improved to 14 dB postoperatively. In the control group, the average air-bone gap was 19 dB preoperatively, and it improved to 13 dB postoperatively. There was no statistically significant difference between the MRSA and control groups.

Conclusions: Tympanoplasty without mastoidectomy showed efficacy in MRSA-infected COM.

MeSH terms

  • Adult
  • Antibiotic Prophylaxis
  • Audiometry, Pure-Tone
  • Case-Control Studies
  • Chronic Disease
  • Female
  • Hearing
  • Humans
  • Male
  • Mastoid
  • Methicillin-Resistant Staphylococcus aureus*
  • Middle Aged
  • Otitis Media / microbiology*
  • Otitis Media / surgery*
  • Retrospective Studies
  • Staphylococcal Infections / complications*
  • Staphylococcal Infections / surgery*
  • Treatment Outcome
  • Tympanoplasty / methods*