scholarly journals Revision surgery for chronically discharging mastoid cavities: mastoid obliteration with canal wall reconstruction versus non-obliteration surgery

2021 ◽  
Author(s):  
Hylke F. E. van der Toom ◽  
Marc P. van der Schroeff ◽  
Tim L. Molenaar ◽  
Mick Metselaar ◽  
Anne van Linge ◽  
...  
Keyword(s):  
Revision Surgery ◽  
Primary Outcome ◽  
Clinic Visit ◽  
Canal Wall ◽  
Mastoid Obliteration ◽  
Posterior Canal ◽  
Group A ◽  
Study Population ◽  
Canal Wall Down ◽  
Canal Wall Reconstruction

Abstract Purpose To evaluate the surgical results of revision canal wall down (CWD) surgery for chronically discharging mastoid cavities and to compare the non-obliteration approach to mastoid obliteration with canal wall reconstruction. Methods This is a retrospective cohort study. All adult patients (≥ 18 years) who underwent revision surgery for chronically draining mastoid cavities between January 2013 and January 2020 were included. Primary outcome measures included the dry ear rate, complications and postoperative hearing. Results 79 ears were included; 56 ears received revision CWD with mastoid obliteration and posterior canal wall reconstruction and 23 ears received CWD without mastoid obliteration. The dry ear rate at the most recent outpatient clinic visit (median 28.0 months postoperative) was significantly higher in the obliteration group with 96.4% compared to 73.9% for the non-obliteration group (p = .002). There were no differences in audiological outcome and incidence of complications between the two techniques. Conclusion We show that in our study population revision CWD surgery with mastoid obliteration and posterior canal wall reconstruction is superior to revision CWD surgery without mastoid obliteration in the management of chronically discharging mastoid cavities. In the obliteration group, a dry ear was achieved in 96.4% as this was 73.9% in the non-obliteration group. We found no differences in audiological outcome and in incidence of complications between the two techniques.

scholarly journals Mastoid Obliteration Using Bioactive Glass—Our Experience

2021 ◽  
Author(s):  
Anand Velusamy ◽  
Nazrin Hameed ◽  
Aishwarya Anand
Keyword(s):  
Postoperative Complications ◽  
Bioactive Glass ◽  
Secondary Outcome ◽  
Mastoid Cavity ◽  
Canal Wall ◽  
Mastoid Obliteration ◽  
Posterior Canal ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy ◽  
Cavity Obliteration

Abstract Aims The aim of this study was to evaluate the surgical outcome of cavity obliteration with bioactive glass in patients with cholesteatoma undergoing canal wall down mastoidectomy with reconstruction of the canal wall. Materials and Methods A prospective study was conducted over a period of 3 years on 25 patients who underwent mastoid obliteration with bioactive glass following canal wall down mastoidectomy for cholesteatoma. The primary outcome measure was the presence of a dry, low-maintenance mastoid cavity that was free of infection, assessed, and graded according to the grading system by Merchant et al at the end of 1 and 6 months postoperatively. Secondary outcome measures included presence of postoperative complications like wound infection, posterior canal wall bulge, and residual perforation. Results Out of the 25 patients on whom this study was conducted, at the end of 1 month 60% had a completely dry ear, 28% of patients had grade 1, and 12% had grade 2 otorrhea at the end of the first month. At the end of 6 months, 72% had a completely dry ear, while 20% had grade 1 and 8% had grade 2 otorrhea. There were no cases with grade 3 otorrhea during the entire follow-up period. Postoperative complications of the posterior canal bulge were noted in two patients (8%), and one patient (4%) had a residual perforation. Conclusion Mastoid cavity obliteration with bioactive glass is an effective technique to avoid cavity problems.

Canal wall reconstruction and mastoid obliteration in canal wall down tympanomastoidectomized patients

2009 ◽  
Vol 129 (9) ◽  
pp. 955-961 ◽  
Author(s):  
Won-Sang Lee ◽  
Sung Huhn Kim ◽  
Won-Sang Lee ◽  
Sung Huhn Kim ◽  
In Seok Moon ◽  
...  
Keyword(s):  
Canal Wall ◽  
Mastoid Obliteration ◽  
Canal Wall Down ◽  
Canal Wall Reconstruction

Posterior canal wall reconstruction with a composite cartilage titanium mesh graft in canal wall down tympanoplasty and revision surgery for radical cavities

2006 ◽  
Vol 120 (10) ◽  
pp. 832-836 ◽  
Author(s):  
H Sudhoff ◽  
D Brors ◽  
A Al-Lawati ◽  
E Gimenez ◽  
S Dazert ◽  
...  
Keyword(s):  
External Auditory Canal ◽  
Revision Surgery ◽  
External Ear ◽  
Titanium Mesh ◽  
Canal Wall ◽  
Ear Canal ◽  
Mesh Graft ◽  
External Ear Canal ◽  
Canal Wall Down ◽  
Canal Wall Reconstruction

Objectives: To investigate posterior external ear canal wall reconstruction with a composite cartilage titanium mesh graft in canal wall down tympanoplasty and revision surgery for open mastoids.Study design: Retrospective case review.Setting: Tertiary referral centre.Methods: As a preliminary study, 15 selected patients underwent reconstruction of a posterior ear canal wall defect with titanium mesh. Large defects of the posterior external auditory canal wall, resulting from canal wall down tympanoplasty or present in revision surgery, were eliminated by reconstruction using a titanium mesh. The mesh was covered with conchal cartilage and attached to the cortical mastoid bone using 3-mm titanium screws.Results: All patients maintained a normal contour of the external ear canal, without depression, extrusion or infection. There were no failures, based on short-term post-operative controls. However, two procedures had to be revised due to incomplete coverage of the titanium mesh.Conclusions: This study shows that reconstruction of the posterior ear canal wall with a composite cartilage titanium mesh is a valuable method for preserving the morphology of the external auditory canal in selected cases. Problems occurring in canal wall down tympanomastoidectomy and radical cavities may therefore be avoided. However, long-term results have yet to be evaluated.

Cochlear implantation after canal wall down mastoidectomy — Outcomes after partial mastoid obliteration

2019 ◽  
Vol 46 (4) ◽  
pp. 487-492 ◽  
Author(s):  
Matthias Balk ◽  
David Schwarz ◽  
Philipp Wolber ◽  
Andreas Anagiotos ◽  
Antoniu-Oreste Gostian
Keyword(s):  
Cochlear Implantation ◽  
Canal Wall ◽  
Mastoid Obliteration ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy

scholarly journals Four layers reconstruction of the posterior ear canal wall in one stage surgery

2021 ◽  
Author(s):  
Khaled M. Mokbel Khalefa
Keyword(s):  
Otitis Media ◽  
Recurrent Infection ◽  
Posterior Wall ◽  
Chronic Suppurative Otitis Media ◽  
Canal Wall ◽  
Suppurative Otitis Media ◽  
Posterior Canal ◽  
One Stage ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy

<p class="abstract"><strong>Background:</strong> Canal wall down mastoidectomy are still practiced in cases of chronic suppurative otitis media with cholesteatoma to ensure complete disease removal. The resulting cavity is prone to recurrent infection, chronic discharge and frequent care. Reconstruction of the posterior canal wall should be planned by the surgeon. Various techniques for external auditory canal (EAC) reconstruction have been recommended to eliminate open cavity problems. The surgeon should choose the type of grafts either autologous, homografts or synthetic materials. Furthermore, the surgeon should decide whether to do the reconstruction either immediate in the first stage of surgery or delayed as a second stage.</p><p class="abstract"><strong>Methods:</strong> In this study, the ridge was reconstructed at the same time of mastoidectomy by autologous tissues. The presenting study reconstructed the posterior canal wall in four layers; skin, perichondrial flap, cartilage and periosteal flap in that order from the meatal side to the mastoid side. The presenting study included 48 patients (32 males and 16 females) with age ranged from 18-55 and 20-50 years. All included patients were presented at the outpatient clinic with unilateral chronic suppurative otitis media with persistent discharge. They had been operated at our tertiary hospital between January. 2012 to March 2014.</p><p class="abstract"><strong>Results:</strong> Successful reconstruction was obtained in all cases, with no dehiscence or necrosis.</p><p class="abstract"><strong>Conclusions:</strong> The reconstruction of the posterior wall by the four layers technique was successful and efficient. It is recommended to do this repair concomitantly with canal wall down mastoidectomy as one stage surgery.</p>

Posterior Canal Wall Reconstruction With Titanium Micro-Mesh and Bone Pat??Age

2002 ◽  
Vol 112 (4) ◽  
pp. 753-756 ◽  
Author(s):  
Carlo Zini ◽  
Nicola Quaranta ◽  
Fabio Piazza
Keyword(s):  
Canal Wall ◽  
Posterior Canal ◽  
Canal Wall Reconstruction

Revision Surgery for Chronic Otitis Media: A Learning Experience

1998 ◽  
Vol 107 (6) ◽  
pp. 486-491 ◽  
Author(s):  
Jan E. Veldman ◽  
W. Weibel Braunius
Keyword(s):  
Otitis Media ◽  
Revision Surgery ◽  
Learning Experience ◽  
Chronic Otitis Media ◽  
Canal Wall ◽  
Long Term Follow Up ◽  
Surgical History ◽  
History Of ◽  
Canal Wall Down ◽  
Residual Air

The objective of this study was to evaluate, during a long-term follow-up period, the results of revision surgery for chronic otitis media with or without cholesteatoma. Intact canal wall and canal wall down procedures were performed. The surgical history of every patient was assessed before the operation. A dry, relatively safe, and disease-free ear was created in 90% of the reoperated ears (N = 389). The recurrence rate of cholesteatoma was 5% for the total group. Reperforations of the tympanic membrane occurred in 10%, and persistent or recurrent otorrhea was present in 10% of cases. The functional hearing results were quite satisfactory. A residual air-bone gap of ≤30 dB was reached in 70.3% of the cases after revision tympanoplasty only (N = 41). Revision mastoidectomy with revision tympanoplasty as a one-stage procedure led subsequently, in 76% of intact canal wall procedures (N = 113) and 55% of canal wall down procedures (N = 98), to a residual air-bone gap of ≤30 dB.

Sign in / Sign up

Export Citation Format

Share Document