Long-term status of middle-ear aeration post canal wall down mastoidectomy

2019 ◽  
Vol 133 (8) ◽  
pp. 662-667 ◽  
Author(s):  
T Ezulia ◽  
B S Goh ◽  
L Saim

AbstractBackgroundRetraction pocket theory is the most acceptable theory for cholesteatoma formation. Canal wall down mastoidectomy is widely performed for cholesteatoma removal. Post-operatively, each patient with canal wall down mastoidectomy has an exteriorised mastoid cavity, exteriorised attic, neo-tympanic membrane and shallow neo-middle ear.ObjectiveThis study aimed to clinically assess the status of the neo-tympanic membrane and the exteriorised attic following canal wall down mastoidectomy.MethodsAll post canal wall down mastoidectomy patients were recruited and otoendoscopy was performed to assess the neo-tympanic membrane. A clinical classification of the overall status of middle-ear aeration following canal wall down mastoidectomy was formulated.ResultsTwenty-five ears were included in the study. Ninety-two per cent of cases showed some degree of neo-tympanic membrane retraction, ranging from mild to very severe.ConclusionAfter more than six months following canal wall down mastoidectomy, the degree of retracted neo-tympanic membranes and exteriorised attics was significant. Eustachian tube dysfunction leading to negative middle-ear aeration was present even after the canal wall down procedure. However, there was no development of cholesteatoma, despite persistent retraction.

2017 ◽  
Vol 96 (10-11) ◽  
pp. 426-432
Author(s):  
Z. Jason Qian ◽  
Amy M. Coffey ◽  
Kathleen M. O'Toole ◽  
Anil K. Lalwani

Benign middle ear tumors represent a rare group of neoplasms that vary widely in their pathology, anatomy, and clinical findings. These factors have made it difficult to establish guidelines for the resection of such tumors. Here we present 7 unique cases of these rare and diverse tumors and draw from our experience to recommend optimal surgical management. Based on our experience, a postauricular incision is necessary in nearly all cases. Mastoidectomy is required for tumors that extend into the mastoid cavity. Whenever exposure or hemostasis is believed to be inadequate with simple mastoidectomy, canal-wall-down mastoidectomy should be performed. Finally, disarticulation of the ossicular chain greatly facilitates tumor excision and should be performed early in the procedure.


2019 ◽  
pp. 014556131987978 ◽  
Author(s):  
Sherif M. Askar ◽  
Ibrahim M. Saber ◽  
Mohammad Omar

Objectives: Mastoid reconstruction principle had been described to overcome problems of chronic discharging cavity. Different materials were used; nonbiologic materials seem to be less preferred. Platelet-rich plasma (PRP) could promote the regeneration of mineralized tissues. In this work, the authors present a simple and easy technique for mastoid reconstruction with PRP and cortical bone pate. Methods: The study design is a case series. Patients had mastoid reconstruction after canal wall down mastoidectomy using PRP and cortical bone pate. Results: This study included 21 patients: 9 males, and 12 females. Sixteen patients had left side disease. All surgical procedures were conducted smoothly within 90 to 135 minutes with no stressful events had been reported. At 12 to 16 months of follow-up, external canal stenosis and mastoid fistulas were not reported. Good healing of the tympanic membrane was seen in 18 patients. No radiological signs suggestive of recurrence were detected and the reconstructed mastoid cavity was smooth and well aerated. Residual tympanic membrane perforations were detected in 3 patients. Conclusion: Autologous materials (PRP and bone pate pate) after canal wall down mastoidectomy appear to be a reliable and effective choice for mastoid reconstruction.


1970 ◽  
Vol 16 (1) ◽  
pp. 3-8
Author(s):  
Delwar Hossain ◽  
Mosleh Uddin ◽  
Ahmmad Taous ◽  
Kazi Shameemus Salam ◽  
Rafiqul Islam

Canal wall window (CWW) tympanomastoidectomy is a modified form of attico-antrostomywhich can be a substituted for canal wall down procedure. A retrospective study of 84 casesof CWW tympanomastoidectomy were collected from department of otolaryngology and Headnecksurgery, BSMMU and ENT Foundation Hospital, Dhaka from June 2005 to July 2009.In this study majority of the patients were 16 to 48 years 57(67.86%). Male female ratio was3:1. Most of the patients were found cholesteatoma 27 (32.14%), granulation tissue 25(29.76%),retraction pocket 22(26.19%),Postoperative hearing gain (mean three frequency pure tone air bone gap) assessed 3 monthsafter primary surgery, most of the patients 34(40.48%) had gain 20dB+, 26 patients (30.95%)had gain 10dB+,18 patients (2143%) had gain 30dB+.Materials used in tympano-ossiculoplasty were chonchal cartilage, sculptured incus, PORPand TORP. Most of the patients we used incus reposition 36(42.86%), cartilage ossiculoplasty28(33.33%), PORP 12(14.29%) and TORP 8 (9.52%).Post operative followup of the patient was done in 1 month, 3 month and 6 month intervals andcondition of external auditory canal assessed. Dry ear were found 70 patients (83.33%), moistear were found 8 patients (9.52%) and 6 patients (7.14%) were found purulent dischargingears and later canal wall down mastoidectomy done .Key words: Canal wall window; Tympanomastoidectomy.DOI: 10.3329/bjo.v16i1.5774Bangladesh J Otorhinolaryngol 2010; 16(1): 3-8


2018 ◽  
Vol 17 (2) ◽  
pp. 307-310
Author(s):  
Ahmad Hafiz Ali ◽  
Zulkiflee Salahuddin ◽  
Mohd Khairi MD Daud ◽  
Rosdan Salim

Bilateral congenital mesotympanic cholesteatoma is a very rare disease. It can present differently from ordinary congenital cholesteatoma. We report a case of bilateral congenital cholesteatoma diagnosed at age of 22 years old. She presented with bilateral intermittent ear discharge since 10 years old that worsening two weeks prior to her presentation to our clinic and associated with bilateral reduced hearing. Clinically there was intact tympanic membrane with retraction of the mesotympanic area with present of mass medial to tympanic membrane. CT scan imaging showed there was soft tissue in the bilateral middle ear cavity with intact scutum and ossicles. Patient undergone canal wall down procedure and the diagnosis of congenital mesotympanic cholesteatoma was confirmed with present of cholesteatoma sac at the posterosuperior part, as opposed to anterosuperior quadrant, where the common site for congenital cholesteatoma.Bangladesh Journal of Medical Science Vol.17(2) 2018 p.307-310


2019 ◽  
Vol 129 (6) ◽  
pp. 1453-1457 ◽  
Author(s):  
Mohammad Faramarzi ◽  
Reza Kaboodkhani ◽  
Sareh Roosta ◽  
Negar Azarpira ◽  
Mahmood Shishegar ◽  
...  

2004 ◽  
Vol 113 (11) ◽  
pp. 872-876 ◽  
Author(s):  
Maria Izabel Kos ◽  
Pierre Montandon ◽  
Rodrigo Castrillon ◽  
Jean-Philippe Guyot

1995 ◽  
Vol 109 (7) ◽  
pp. 583-589 ◽  
Author(s):  
Sanjaya Bhatia ◽  
Sandeep Karmarkar ◽  
Giuseppe DeDonato ◽  
Cemil Mutlu ◽  
Abdelkader Taibah ◽  
...  

AbstractManaging patients with failed canal wall down mastoidectomy, requires a meticulous approach to control the disease and restore hearing. The present article reviews the causes of failure of the primary procedure and pitfalls encountered in 105 patients referred to our centre for revision canal wall down mastoidectomy. At post-revision surgery there were no cases with residual or recurrent cholesteatoma. The failures in our revision procedure were due to tympanic membrane perforation which occurred in five percent (n = 4) and intermittent otorrhoea in two percent (n = 2). A dry cavity with adequate middle ear space allowed for optimum audiological function even in revision canal wall down procedures.


Author(s):  
Anand Velusamy ◽  
Nazrin Hameed ◽  
Aishwarya Anand

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.


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