Revision surgery for chronic otitis media: Characteristics and outcomes in comparison with primary surgery

Objectives: To analyze the characteristics and outcomes of revision surgery for chronic otitis media (COM) with or without cholesteatoma, and to compare with those of primary surgery. Methods: A retrospective chart review was performed on 208 patients who underwent revision surgery for COM over an 8-year period (1997-2004) and 51 patients who underwent a primary canal wall down mastoidectomy (CWDM), and were followed for more than 12 months. Results: Recurrent or residual cholesteatoma was found in 49.5% of cases. The mastoid tip and perisinal air cells were the most frequent sites of residual air cells. As a result of revision surgery, a dry and safe ear was achieved in 88.5% of patients. A residual air-bone gap (ABG) of ≤30 dB was achieved in 70.1% of cases with a revision CWDM with ossiculoplasty. In comparison with 51 patients who underwent primary CWDM, the disease control rate was not different. However, postoperative hearing result after ossiculoplasty was worse and longer healing time was required after revision surgery. Conclusion: The characteristics and surgical outcome of recurrent COM must be fully understood for complete control of the disease.