Intraoperative Findings during Canal Wall Down Mastoidectomy in Children

Abstract

Objective: The main objective of this study is to assess the intraoperative finding during canal wall down mastoidectomy in paediatric patients undergoing surgery for unsafe type of chronic suppurative otitis media (CSOM) attending ENT OPD of Kathmandu Medical College. Materials and Methods: Fifty patients of age group 4 to 13 years who were suffering from unsafe type of CSOM with or without cholesteatoma were taken for the study. The study period was two years from April 2007 to March 2009. The operative findings like extent of cholesteatoma in different location of middle ear cleft, mastoid bony landmarks, and ossicular chain condition and otogenic complication were identified during canal wall down mastoidectomy. Result: Of the 50 patients 32 (64%) were boys and 18(36%) were girls. The age ranged from 4 years to 13 years. Majority of patients had cholesteatoma with granulation diseases (72%) followed by granulation diseases (16%). Involvement of disease in attic, aditus, antrum and mesotympanum were found to be high in majority of cases (82%) with high percentage of necrosis of incus (56%). Conclusion: The primary disease found in patients undergoing canal wall down mastoidectomy (CWDM) was cholesteatoma combined with granulation in72%, granulation in 16% and cholesteatoma in12%. Key words: Canal Wall Down; ENT; Mastoidectomy; Chronic Suppurative Otitis Media (CSOM) DOI: http://dx.doi.org/10.3126/jnps.v31i3.5357 J Nep Paedtr Soc 2011;31(3):184-187

Ossicular Chain Status in Chronic Suppurative Otitis Media in Adults

“…Kartush found erosion of long process of incus with an intact malleus handle and stapes superstructure (type A) as the most common ossicular defect [17]. Shreshtha et al and Mathur et al also reported similar findings in unsafe CSOM [18,19].…”

“…Sade et al reported stapes involvement in unsafe CSOM to be 36.00% [5]. Shreshtha et al found involvement of stapes superstructure in 15.00% cases of unsafe CSOM [18]. Motwani et al reported stapes arch necrosis in 30.00% cases of CSOM [20].…”

Our experience of unsafe ear

“…Our study 75 Austin [9] 15.5 Sade et al [10] 36 Shrestha et al [11] 15 Motwani et al [12] 30 Varshney et al [5] 51.67…”

Ossicular Involvement and Types of Pathology in Chronic Otitis Media Squamous Active Disease

“…In the present study, the most common pathology was found to be mixed (52 %), followed by granulation tissue (36 %) and cholesteatoma (12 %). 9 One of the observational study demonstrated that cholesteatoma with granulation was present in 72 %, granulation tissue in 16 % and cholesteatoma in 12 % 9 . Involvement of tympanic and mastoid cavities was seen in majority of cases.…”