My daughter age 12 is scheduled for the above procedure on the 18th of this month.
My question to you is this. She has already had this surgery a year ago (Nov. 1) and at that time they did tell us it was likely it would need another surgery, and they are now saying yes she should have the surgery though they don't see anything, just to be safe... they do say it is elective so this makes me wonder if I should hold off and see if a problem arises or just go with the flow.
If you need to know more information just let me know and I would be glad to tell you.
Thank you so much.
Reply: --------------------
What you are describing is known as a "second-look" operation. It is commonly performed in the management of cholesteatoma, a condition where a cystic mass of skin-like elements invades the middle ear and mastoid bone causing bony destruction and infection and requires surgery known as a tympanomastoidectomy. The decision to recomment a "second-look" a year or so later is related to the following:
1) Concern that microscopic elements may have been left behind after the initial operation which can remain viable causing a recurrence of the condition beneath an intact and otherwise normal appearing ear drum.
2) It would typically take an average of up to a year for any residual microscopic elements to grow to sufficient size to be able to be seen with the aid of a microscope, but not long enough to cause any further damage.
3) Concerns about extension of the cholesteatoma into areas of the middle ear and mastoid at the time of the original operation that are frequently very difficult to visualize even with a microscope.
In summary, such a recommendation is made in order to verify that the cholesteatoma has been successfully eradicated thus avoiding the alternative which is finding out that the cholesteatoma has recurred only after it has caused further damage or infection. The need for a "second-look" is highly dependent upon factors seen at the time of the original operation and the judgment of the original surgeon.
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Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
NOTICE: OFCN is not engaged in the rendering of professional medical services. The information contained on this system or any other OFCN system should not supplant individual professional consultation. It is offered exclusively as a community education service. Advice on individual problems must be obtained directly from a professional.
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