A comparative study of hearing outcomes in canal wall up versus canal wall down mastoidectomy in our experience

Abstract

<p class="abstract"><strong>Background:</strong> COM causes considerable morbidity with ear discharge, conductive hearing loss and complications. Ossicular reconstruction is a surgical procedure which intends to improve the quality of hearing and life in such patients. Comparison of the outcomes will help to determine the merits or demerits of a particular procedure.</p><p class="abstract"><strong>Methods:</strong> The study was conducted in the Department of ENT, VIMS, Bellary during the period from December 2010 to May 2012. All the patients with CSOM with ossicular erosion suggested by conductive hearing loss more than 40dB were included in the study. A detailed history taking, thorough clinical examination was done for these patients. Before and after the procedure pure tone audiometry was done to assess the hearing outcome. Post operatively PTA was done in 6<sup>th</sup> week, 3<sup>rd</sup> month, 6<sup>th</sup> month follow up. Hearing improvement was analysed according to the type of procedure. The data collected was tabulated and subjected to statistical analysis. </p><p class="abstract"><strong>Results:</strong> This study compared the outcomes of hearing gain in canal wall up versus canal wall down mastoidectomy surgeries. Hearing gain was better in canal wall up mastoidectomy (18.36 dB) than canal wall down mastoidectomy surgeries.</p><p class="abstract"><strong>Conclusions:</strong> Hearing outcome was better in intact canal wall mastoidectomy than canal wall down mastoidectomy in our study.</p><p class="abstract"> </p>

The Outcome of Canal Wall Up versus Canal Wall Down Mastoidectomy in Cholesteatoma

“…Also similar to our study, Bhat et al [6] found the average hearing gain in CWU mastoidectomy was better 18.36 dB than CWD mastoidectomy 11.03 dB with statistically significant difference [ANOVA F-test: -3.43, p=0.001]. Osborn et al [13] provided information on hearing outcomes for 320 patients.…”

“…Partial ossicular replacement prosthesis [PORP] was found to be significantly more frequent in group B. In studies conducted by Lasisi [17] and Bhat et al [6] , it was noted that the hearing benefits from canal wall down [CWD] procedures were minimal, and further hearing augmentation may be necessary with a second look surgery and ossiculoplasty, bone anchored hearing aid, or a hearing aid. These findings were consistent with the results of our study.…”

“…To determine the appropriate sample size for the study, we used version 3 of the power and sample size program. Based on the results of a previous study [6] , which found that the mean air-bone gap [ABG] in patients managed by CWD and CWU was 52 and 41, respectively, with a standard deviation of 18, we calculated that a sample size of at least 40 patients per group was necessary to achieve a 95% confidence level and study power of 80%.…”

Hearing improvement among children with cholesteatoma who underwent canal wall up and canal wall down surgical management

“…It was found that CWU had improved hearing better (18.36 dB) than that of the CWD technique. 9 In another comparative study, Kalita S et al observed that 3.3% of patients had an air-born gap (ABG) less than 30 dB in the CWD group while 6.67% in Intact Canal Wall (IWC) mastoidectomy. This ABG remained the same in 3.3% of patients three months post-operatively while it was observed in 20% of the IWC group.…”

A Comparative Study of Results of Canal Wall Up & Canal Wall down Mastoidectomy as a Surgical Treatment for Cholesteatoma

“…Similar results to our study were present in study done by Bhat S. et al . 4 They conducted study & compared the outcomes of hearing gain in canal wall up versus canal wall down mastoidectomy surgeries. Hearing gain was better in canal wall up mastoidectomy (18.36 dB) than canal wall down mastoidectomy surgeries.…”