Retrospective Analysis of Prognostic Factors following Mastoidectomy Surgery and How These Results May Help with Creating a Pro-Equity Clinical Approach for our Special Demographic in Aotearoa
Authors List
Dugena, O. University of Otago, Wellington, New Zealand
Larsen, P. Department of Surgery & Anesthesia, University of Otago, Wellington
Garland, R. Capital & Coast DHB Ear, Nose & Throat Services
Aim: This study examined characteristics of patients presenting requiring mastoidectomy surgery for treatment of cholesteatoma and length of clinical follow up required.
Method: We performed a retrospective analysis of all cases of mastoidectomy at a single institute by a surgeon over a period of 10 years (2008-2018). Patients were followed up at 2 weeks and had on going follow up until no intervention or routine cares were needed.
Results: There were 158 ears that met our inclusion criteria for our study. The majority of the operations were by intact canal wall approach (90/158). 28.7% of the cohort were smokers, with 52% that quit smoking during the process, making it difficult to analyze its long-term effects. There was a high proportion of Maori patients making up 30% of the database. The mean age of Maori patients having mastoidectomy was 36 (SD=15.6) vs non-Maori being around 45 (SD=21.4) showing Maori patients presented at a significantly younger age (p=.005). Patients with disease of mesotympanic (MSTMP) origin were more likely to have eroded stapes superstructure (76%) in comparison to attic in origin (24%, p=.002) with a trend towards stapes involvement in Maori patients (48%, p=0.3). Maori patients with MSTMP origin were also found to have a further follow up period by a mean of 674 days vs non-Maori (p=0.025). Other factors associated with a need for longer follow up were radical mastoidectomy procedures when compared with intact canal wall by a mean of 330 days (p=0.005).
Conclusion: Understanding significant factors that alter follow up length such as ethnicity, operation type, disease origin and stapes superstructure status is critical to enabling pro-equity clinical management and minimizing resource use of the hospital system.
Dugena, O. University of Otago, Wellington, New Zealand
Larsen, P. Department of Surgery & Anesthesia, University of Otago, Wellington
Garland, R. Capital & Coast DHB Ear, Nose & Throat Services
Aim: This study examined characteristics of patients presenting requiring mastoidectomy surgery for treatment of cholesteatoma and length of clinical follow up required.
Method: We performed a retrospective analysis of all cases of mastoidectomy at a single institute by a surgeon over a period of 10 years (2008-2018). Patients were followed up at 2 weeks and had on going follow up until no intervention or routine cares were needed.
Results: There were 158 ears that met our inclusion criteria for our study. The majority of the operations were by intact canal wall approach (90/158). 28.7% of the cohort were smokers, with 52% that quit smoking during the process, making it difficult to analyze its long-term effects. There was a high proportion of Maori patients making up 30% of the database. The mean age of Maori patients having mastoidectomy was 36 (SD=15.6) vs non-Maori being around 45 (SD=21.4) showing Maori patients presented at a significantly younger age (p=.005). Patients with disease of mesotympanic (MSTMP) origin were more likely to have eroded stapes superstructure (76%) in comparison to attic in origin (24%, p=.002) with a trend towards stapes involvement in Maori patients (48%, p=0.3). Maori patients with MSTMP origin were also found to have a further follow up period by a mean of 674 days vs non-Maori (p=0.025). Other factors associated with a need for longer follow up were radical mastoidectomy procedures when compared with intact canal wall by a mean of 330 days (p=0.005).
Conclusion: Understanding significant factors that alter follow up length such as ethnicity, operation type, disease origin and stapes superstructure status is critical to enabling pro-equity clinical management and minimizing resource use of the hospital system.
