Rehabilitation of Canal Wall Down Mastoidectomy Using a Titanium Ear Canal Implant

Devèze, Arnaud; Rameh, Charbel; Puchol, M. Sanjuan; Lafont, B.; Lavieille, Jean‐Pierre; Magnan, Jacques

doi:10.1097/mao.0b013e3181c9960d

Cited by 23 publications

(20 citation statements)

References 17 publications

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“…It can be avoided by the application of antibiotic powder on the bone pate before using. Adequate blockage of the attic with a generous piece of cartilage should be performed [10,22] .…”

Section: Discussionmentioning

confidence: 99%

Single Stage Canal Wall Down Mastoidectomy with Reconstruction of the Canal Wall: 5 Years’ Experience in Fayoum Province, Egypt

Qotb

Fawzy²,

Ragab³

2017

Int Adv Otol

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OBJECTIVE:Removing the posterior canal wall or canal wall down mastoidectomy (CWDM) for the management of cholesteatoma remains controversial. We advocate partial removal of the posterior canal wall for complete eradication, followed by canal wall defect reconstruction to restore the normal anatomy and avoid the complications of CWDM. MATERIALS and METHODS:Sixty-four patients with cholesteatoma (71 ears) were included. This study was conducted between 2009 and 2012. Single-stage mastoidectomy was performed by drilling the upper third of the posterior canal wall together with the attic, leaving the remaining lower two-thirds intact. Conchal cartilage was used to reconstruct the upper third of the posterior canal wall. RESULTS:The mean±SD healing time was 7.5±2.3 (range, 4-14) weeks. The mean±SD preoperative and postoperative air bone gaps were 35.8±6.2 dB and 22.9±6.8 dB, respectively. Nearly 84.2% of the patients were followed up for at least 3 years and had dry healthy ears. Complications were noted and statistically examined. CONCLUSION:Single-stage CWDM with reconstruction of the posterior canal wall, ossicular chain, and tympanic membrane is a safe and reliable technique with the advantages of Canal wall up Mastoidectomy (CWUM). Its recurrence rate is 4.2%. Longer follow-up durations are required.

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“…It can be avoided by the application of antibiotic powder on the bone pate before using. Adequate blockage of the attic with a generous piece of cartilage should be performed [10,22] .…”

Section: Discussionmentioning

confidence: 99%

Single Stage Canal Wall Down Mastoidectomy with Reconstruction of the Canal Wall: 5 Years’ Experience in Fayoum Province, Egypt

Qotb

Fawzy²,

Ragab³

2017

Int Adv Otol

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“…In recent decades, several modifications of the CWU technique have been described. Most of them deal with the management of the posterior canal wall and its possible reconstruction to regain a physiological external auditory canal [6,9,13,14,24,25]. Concerning the classical CWD procedure with an open mastoid cavity, the emphasis of most studies has been on the management of postoperative chronic otorrhea [2,13,20,21,26].…”

Section: Discussionmentioning

confidence: 99%

“…Most of them deal with the management of the posterior canal wall and its possible reconstruction to regain a physiological external auditory canal [6,9,13,14,24,25]. Concerning the classical CWD procedure with an open mastoid cavity, the emphasis of most studies has been on the management of postoperative chronic otorrhea [2,13,20,21,26]. Several partial or complete obliteration techniques with excellent anatomical results have been published [27,28,29,30].…”

Section: Discussionmentioning

confidence: 99%

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Audiometric Results of Open Cavity Tympanomastoidectomy in Advanced Attic Cholesteatoma

Minovi¹,

Dombrowski²,

Shahpasand³

et al. 2015

ORL

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In this retrospective study, we evaluated the audiometric results after using the retrograde mastoidectomy technique with open mastoid cavity for the removal of extended attic cholesteatomas. The described technique was used for cholesteatoma removal in 168 adult patients with an average follow-up time of 12 months. Due to cholesteatoma extension far into the mastoid, the disease was eradicated by the canal wall down (CWD) technique with the creation of an open mastoid cavity. Primary surgery was carried out in 47% of ears, with the remaining 53% representing revision surgery. In all cases, a classical CWD with an open mastoid cavity and partial obliteration with cartilage was created. A dry ear was achieved in 94% of cases. A postoperative air-bone gap ≤20 dB was achieved in 42.9% of the operated ears. 9.3% (n = 15) of the operated ears showed a postoperative air-bone gap >30 dB. Important factors leading to significantly better hearing restoration were an intact malleus, the use of alloplastic titanium prostheses and primary surgery. Although most cholesteatomas nowadays can be eradicated with the canal wall up technique, in far advanced cholesteatomas, the CWD technique can be applied with acceptable postoperative hearing results.

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“…In recent years Deveze etc. reported reconstruction of mastoid antrum with titanium plate, with a very high postoperative dry ear rate but still un-ideal hearing [6]. We also filled old mastoid antrum with autogenous iliac, similarly with an unsatisfied hearing and only 65 % of effective postoperative air-bone gap reduced to more than 10 dB [7].…”

Section: Introductionmentioning

confidence: 99%

Comparative Analysis of Effects of Reconstruction and Radical Treatment of the Posterior Ear Canal Wall Using Periosteal Osteocomma and Mastoid Antrum Ventilation

Tong¹,

Chen²,

Deng³

et al. 2013

Indian J Otolaryngol Head Neck Surg

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To analyze the results of repair defect of the ear canal with autologous bone containing periosteum and hearing reconstruction and postoperative inflation. Retrospective analysis of the 40 cases of surgeries conducted by senior surgeon. All cases received full open surgeries. Preoperative air conduction (AC) was 67.47 ± 14.32 dBHL, and GAP was 45.95 ± 12.63 dBHL. These cases were divided into two groups: the first 20 ears received repair surgery for radical mastoid cavity with bone slice containing periosteum combined with ear ossicle remodeling, namely the bone slice group. For another 20 ears, inflator was additionally used and the mastoid antrum cavity was inflated twice a day, namely the inflation group. Follow-up: 9-60 months (median follow-up of 26 months). Statistical analysis: U test was adopted. All ear canal showed a smooth appearance. Eight cases received CT scans and presenting re-gasification of attic and/or mastoid cavity. Hearing: AC of 47.32 ± 15.63 dBHL, and GAP of 18.28 ± 15.28 dBHL, both P values were \0.01 as compared with that before operation, and the difference was highly significant. 23 cases showed GAP \20 dB, and one case showed GAP [20 at follow-up, but narrowing was [30 dB, and these 24 cases were successful case, with a success rate = 60 %. 16 cases with GAP \10 dB, although 4 cases with GAP [10 dB, narrowing was [30 dB, thus the 20 cases were markedly effective, and with ratio = 50 %. The gap of 30 cases was narrowed more than 15 dB, although two cases showed gap narrowing less than 15 dB, postoperative GAP was less than 10 dB, both were valid, with an efficacy of 32/40 = 80 %, 18 cases (45 %) with AC \40 dBHL. Sub-group analysis: age: group P \ 0.05 when the two groups were compared, difference in ages of the two groups were significant, and the age of the inflation group was older. Both GAP and AC of the two groups showed no significant difference before and after the surgery. One case in the bone slice group showed poor postoperative hearing, adhesion was found between the mesotympanum and attic in reoperation, and best result of GAP Close to less than 10 dB was obtained using the decomposition method after inflation. Bone slice containing periosteum can be used for reconstruct the normal ear canal. Auxiliary inflation of middle ear can even promote the tympanic re-gasification and hearing recovery.

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Rehabilitation of Canal Wall Down Mastoidectomy Using a Titanium Ear Canal Implant

Cited by 23 publications

References 17 publications

Single Stage Canal Wall Down Mastoidectomy with Reconstruction of the Canal Wall: 5 Years’ Experience in Fayoum Province, Egypt

Single Stage Canal Wall Down Mastoidectomy with Reconstruction of the Canal Wall: 5 Years’ Experience in Fayoum Province, Egypt

Audiometric Results of Open Cavity Tympanomastoidectomy in Advanced Attic Cholesteatoma

Comparative Analysis of Effects of Reconstruction and Radical Treatment of the Posterior Ear Canal Wall Using Periosteal Osteocomma and Mastoid Antrum Ventilation

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