Obliteration of Radical Cavities and Total Reconstruction Procedure Without Staging After Canal Wall Down Mastoidectomy: Long-term Results

Abstract

ObjectivesWe evaluate the long-term surgical and hearing results using a canal wall down mastoidectomy technique followed by cavities obliteration, canal wall reconstruction and ossiculoplasty without staging.MethodsA total of 44 patients between January 2002 and October 2009 were selected and 27 of them were revision cases. Preoperative and postoperative pure tone average (PTA) and air-bone gap (ABG) were assessed and compared 1 and 4 years after surgery.ResultsThe middle ear was well healed and aerated in 40 patients (90.9%) and the tympanic membrane was intact in 42 patients (95.5%). Recurrent cholesteatoma was found on postoperative follow-up in two of the revision patients (7.4%) but none in the primary patients. Seven patients were found to have partial canal bone absorption, but revision surgery was not required. Over 86.4% of all cases were water resistant. Long-lasting improvement and/or preservation of hearing, with maintenance of PTA-ABG closure in 63.7% of all cases within 20 dB, were obtained.ConclusionThe efficacy of our technique after a canal wall down mastoidectomy is satisfactory, and the rate of complication is acceptably low. We believe that our technique could be a convenient method in disease control and providing an excellent basis for hearing restoration simultaneously.

Anatomical, functional and quality‐of‐life results for mastoid and epitympanic obliteration with bioactive glass s53p4: a prospective clinical study

“…Regarding functional results, an overall improvement in hearing was achieved, even though not spectacular. Considering that most of our cases were revision surgeries, our results are in line with the reported literature, and the reconstructed external auditory canal allowed changes in external ear resonance and facilitated the use of hearing aids …”

“…The disadvantages of using autologous materials are donor-site morbidity and the risk of resorption over time. 26 Using biocompatible materials, the most feared complication is infection and its subsequent extrusion. This is why the antibacterial activity of BG granules to the most frequent bacteria involved in chronic otitis seemed very attractive to us.…”

“…Since 1911, many materials, either autologous or biocompatible, have been used for obliteration. The disadvantages of using autologous materials are donor‐site morbidity and the risk of resorption over time . Using biocompatible materials, the most feared complication is infection and its subsequent extrusion.…”

Recidivous cholesteatoma: DWI MR after canal wall up and canal wall down mastoidectomy

“…For the above mentioned disadvantages, some authors carry out reconstruction of posterior wall or obliteration of the cavity using various methods (9,10).…”

The methods of surgical sanation of the difficult to access parts of the middle ear in the patients presenting with chronic suppurative otitis media and concomitant cholesteatoma

“…Несмотря на более чем 100-летний опыт лечения холестеатомы, высокотехнологичное оборудование, вариативные оперативные методики, проблема рецидива заболевания остается актуальной и для современной отохирургии. Даже при соблюдении адекватной хирургической техники частота рецидива заболевания, по данным литературы, составляет 4-26% [3][4][5][6][7][8].…”