Inner Ear Effects of Canal Wall Down Mastoidectomy

Leonetti, John; Kircher, Matthew; Jaber, James J.; Benscoter, Brent J.; Marmora, Joseph; Feustel, Paul J.

doi:10.1177/0194599811432103

Cited by 9 publications

(6 citation statements)

References 16 publications

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“…Dizziness following mastoidectomy is a debilitating symptom. A report of 3 out of 34 patients developing dizziness after CWDM is reported by (15) John P Lionetti, while 7.5% developed Dix hall pike positive BPPV in our sample post operatively. Caloric effect following suction of cavity was noted around 54% (16) by Beutner Drik et al while our 's was for packing and suction 7.5% and 22.5% respectively which is well within reported range.…”

Section: Discussioncontrasting

confidence: 39%

Overall outcome of Modified Radical Mastoidectomy (MRM)

Ekanayake¹,

Vasantharaj²,

Nishari³

et al. 2023

Ceylon J Otolaryngology

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AimsTo compare overall findings of our Modified Radical Mastoidectomy (MRM) practice with the available contemporary standards of international recognition. Design and MethodologyThe cohort included the patients who underwent Modified Radical Mastoidectomy from 2013 to 2018 by the author, who were subjected to a retrospective study. The details obtained from clinic reports were preoperative and postoperative hearing (documented to the end of the fourth post op year), and findings that were documented intraoperatively and post operatively in successive clinic visits. The parameters analysed were hearing improvement, disease extension, anatomical variations, immediate and late post-operative complications. ResultsThere were no evidence of recurrence following the surgical intervention. Postoperative mean air-bone gap had reduced by 9.5dBHL, 5dBHL, 7.44dBHL 4.9dBHL 4.1dBHL 3.75dBHL and 8.18dBHLat 0.125kHz ,0.250kHz, 0.5kHz, 1kHz, 2kHz ,4kHz and 8kHz respectively. Disease involvement was found in Attic, Antrum, Sinus tympani, facial recess, mesotympanum, oval window and posterior sinus, supra tubal recess, sinodural angle cells, sinus sub tympanum, external ear canal, in the descending order of occurrence. 36 audited patients achieved dry ears by the end of second year though some had at least one intermittent wet episode and 4 had continuous persistent wet ears. Intraoperative findings analysis showed 2.5% were observed with perilymph leak, 27.5% had erosion of malleus head by disease, 55% had erosion of incus, 90% intact suprastructure, 97.5% had intact stapes foot plate, 15% had significant dural overhang, 10% had exposed facial nerve, 10% had anterior sigmoid sinus and 2.5% had exposed dura. Immediate post intraoperative complications of 7.5% HB grade 1 facial nerve palsy, 42.5% taste alteration, 5% CSF leak, 25% complaining of disturbing head ache, 7.5% having exposed dura (iatrogenic), 7.5% had dressing removed due to risk of pressure necrosis of pinna or developing Facial nerve palsy and 2.5% (one) patient had the meatus migrating downward due to a connective tissue problem of skin. During post-operative period stitch abscess was noted among 5%, achieved self-cleaning dry ear in 15%, wax build up in the dry ear in 10%. However, over 50% patients had minimum of 1 episode of wet ear in this period. Meatal stenosis and keloid development was noted among 10% and, graft perforation among 20% and 2.5% (one) wound dehiscence. During post-operative period 7.5% developed BBPV and similar percentage had caloric effect during packing of the cavity while 22.5% developed caloric effect during suction of the cavity. ConclusionsThe improvements in hearing when adjunct with Tympanoplasty in this audit keep up with recent compared studies. Further its ability to safely achieve a disease free ear is endorsed and complemented by the low complication rates.

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Section: Discussioncontrasting

confidence: 39%

Overall outcome of Modified Radical Mastoidectomy (MRM)

Ekanayake¹,

Vasantharaj²,

Nishari³

et al. 2023

Ceylon J Otolaryngology

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“…1,8 Reports on SNHL caused by mastoidectomy (drilling) have been conflicting. 2,3,[10][11][12] We found that mastoidectomy status (yes or no) did not correlate significantly with the incidence of SNHL at 4000 Hz. Also, ossiculoplasty status (yes or no) did not significantly affect the likelihood of SNHL development (Table 4).…”

Section: Discussionmentioning

confidence: 63%

Sensorineural Hearing Loss After Surgery to Treat Chronic Otitis Media

Lee

Kim

2020

Ear Nose Throat J

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Objective: We investigated the incidence of sensorineural hearing loss (SNHL) after chronic otitis media (COM) surgery and determined the associated factors. Methods: Data were collected via retrospective medical chart review. Results: Of the 192 patients, 82 underwent tympanoplasty, 26 underwent canal wall up mastoidectomy with tympanoplasty, and 84 underwent canal wall down mastoidectomy with tympanoplasty. After surgery, the average air conduction (AC) hearing threshold improved significantly, from 125 to 1000 Hz, but the average high-frequency AC and bone conduction (BC) hearing thresholds deteriorated significantly. In 21 (11%) cases, the BC hearing threshold worsened by more than 15 dB at 4000 Hz. When we compared these 21 cases to patients in whom hearing was preserved, the former group was found to be significantly younger and had a higher frequency of cholesteatomatous otitis media. However, when comparing the severity of inflammation in patients with temporal bone computed tomography, there was no significant difference between the 2 groups. Conclusions: High-frequency SNHL may develop after surgery to treat COM, especially in young patients with cholesteatoma.

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“…The titles were initially screened for inclusion resulting in further consideration of 485 publications. After screening of abstracts and then full‐text articles, 153 articles were selected for inclusion …”

Section: Resultsmentioning

confidence: 99%