Subtotal Petrosectomy and Blind Sac Closure of the External Auditory Canal: Single-Center Experience with 44 Cases

Abstract

Objective: This study aims to share our experiences with subtotal petrosectomy, cavity obliteration, and blind sac closure of the external auditory canal.Methods: A total of 44 patients who underwent subtotal petrosectomy and cavity obliteration between January 2009 and April 2013 were analyzed retrospectively. Indications of operation, surgical findings, and complications were recorded.Results: Twenty-three male and 21 female patients with a mean age of 42±18 (8-73) years were included in the study. The mean postoperative follow-up period was 22±11 (9-52) months. Seven patients underwent primary cavity obliteration (6 with supralabirentin cholesteatoma and 1 with facial nerve schwannoma; all had total sensorineural hearing loss on the operated side). Obliteration was performed as a secondary procedure in 19 patients who had uncontrolled otorrhea and unserviceable hearing. During the procedure, the implantation processes of a Carina device in 2 patients, active middle ear implant (Vibrant Soundbridge-VSB) in 4 patients, and cochlear implant in 8 patients who had dry mastoidectomy cavities were performed. Removal of the hearing devices was carried out simultaneously with the procedure in 4 patients who had been administered an auditory implant previously. The complications of cerebrospinal otorrhea and mastoid cavity infection developed in 1 patient on the 7 th postoperative day. This had been drained under general anesthesia, and recovery was obtained without any problems. Three patients had skin necrosis localized in the external auditory canal, which was repaired under local anesthesia. Conclusion:Subtotal petrosectomy and cavity obliteration procedure can be a good alternative to prevent recurrent infections and cavity problems in patients who have safe cavities with unserviceable hearing. Additionally, it is gaining more popularity in chronic otitis media patients to secure the implant electrode and to prevent cavity infection if they need to be rehabilitated with cochlear or active middle ear implants.