scholarly journals Platelet-Rich Plasma in Reconstruction of Posterior Meatal Wall after Canal Wall Down Mastoidectomy

2017 ◽  
Vol 22 (02) ◽  
pp. 103-107 ◽  
Author(s):  
Mohammad Elbary ◽  
Wail Nasr ◽  
Samir Sorour
Keyword(s):  
External Auditory Canal ◽  
Platelet Rich Plasma ◽  
Preoperative Evaluation ◽  
Hot Water ◽  
Surgical Reconstruction ◽  
Mastoid Cavity ◽  
Titanium Mesh ◽  
Canal Wall ◽  
Suppurative Otitis Media ◽  
Canal Wall Down

Introduction Canal wall down (CWD) mastoidectomy has many drawbacks, including chronic otorrhea not responding to medications, granulations, dizziness on exposure to cold or hot water, and tendency of debris accumulation in the mastoid cavity, demanding periodic cleaning. Many of these problems can be solved by reconstruction of the posterior meatal wall (PMW). Objectives To assess the results of PMW reconstruction after CWD mastoidectomy for cholesteatoma using titanium mesh and platelet-rich plasma (PRP) mixed with bone pate. Methods This study was conducted with 20 patients that have atticoantral chronic suppurative otitis media. All cases were subjected to CWD mastoid surgery with complete elimination of the disease and reconstruction of the PMW by titanium mesh and the mixture of PRP with bone pate. All patients were exposed to a full preoperative evaluation and full postoperative assessment of the complications, the appearance of the external auditory canal contour, and the hearing gain expressed by the change of the air bone gap postoperatively. Results The PMW reconstructed by titanium mesh and the mixture of PRP with bone pate showed a smooth contour. During the follow-up of 12 to 36 months, the postoperative appearance of the external auditory canal contour was found to be smooth without hidden pouches, irregularities or stenosis in all cases. No granulation, foreign body reaction, or extrusion and/or displacement of the titanium mesh were registered. No facial palsy or recurrent cholesteatoma was reported. Conclusion The surgical reconstruction of the PMW using PRP, bone pate and titanium mesh after CWD mastoidectomy appears to be reliable without considerable complications, giving a smooth appearance to the PMW.

scholarly journals Mastoid Reconstruction With Platelet-Rich Plasma and Bone Pate After Canal Wall Down Mastoidectomy: A Preliminary Report

2019 ◽  
pp. 014556131987978 ◽  
Author(s):  
Sherif M. Askar ◽  
Ibrahim M. Saber ◽  
Mohammad Omar
Keyword(s):  
Tympanic Membrane ◽  
Cortical Bone ◽  
Platelet Rich Plasma ◽  
Case Series ◽  
Stressful Events ◽  
Mastoid Cavity ◽  
Canal Wall ◽  
Tympanic Membrane Perforations ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy

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.

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.

Intact meatal skin, canal wall down approach for difficult cochlear implantation

2009 ◽  
Vol 123 (8) ◽  
pp. 903-906 ◽  
Author(s):  
M J Carfrae ◽  
D Foyt
Keyword(s):  
Middle Ear ◽  
External Auditory Canal ◽  
Cochlear Implantation ◽  
Round Window ◽  
Mastoid Cavity ◽  
Canal Wall ◽  
Posterior Canal ◽  
Facial Recess ◽  
Canal Wall Down

AbstractIntroduction:The intact posterior meatal skin, canal wall down technique for difficult cochlear implantation provides expanded access to the middle ear for cochleostomy in cases of obscured middle-ear landmarks, limited facial recess access and limited mastoid cavity dimensions. Careful preservation of the posterior canal wall skin in this procedure obviates the need for obliteration of the middle-ear mucosa and closure of the external auditory canal.Objectives:To present a canal wall down technique for cochlear implantation, which preserves the intact posterior external auditory canal wall skin. This approach is employed when a standard facial recess cochleostomy is not possible.Methods:Three cases of intact posterior meatal skin, canal wall down cochlear implantation are presented together with long-term follow-up results. In all three cases, implantation via a facial recess approach was not possible. One patient suffered from severe cochlear otosclerosis with obliteration of the round window niche. The second patient had severe middle-ear fibrosis with encasement of all middle-ear structures and obliteration of routine landmarks. The third patient had an anterior sigmoid sinus obscuring access to the facial recess. Cochlear implantation via the canal wall down, intact posterior canal wall skin technique was successfully performed in each of these patients.Results:All three patients were successfully implanted, with full electrode insertion achieved. All patients subsequently became active implant users. One patient did suffer from a minor wound complication post-operatively, unrelated to the approach. Patient follow up ranged from four to six years.

scholarly journals Innovative Method of Using Endoscope in Postoperative Canal Wall Down Mastoid Cavity

2018 ◽  
Vol 56 (211) ◽  
pp. 650-653 ◽  
Author(s):  
Meera Bista ◽  
Nayan Bahadur Mahato ◽  
Deepak Regmi
Keyword(s):  
Study Data ◽  
Mastoid Cavity ◽  
P Value ◽  
Fisher Exact Test ◽  
Wide Field ◽  
Canal Wall ◽  
Cross Sectional ◽  
Significant Difference ◽  
Canal Wall Down ◽  
Mastoid Surgery

Introduction: Poor access to the difficult areas in the middle ear and mastoid cavity is considered as the major reason for failure in mastoid surgery. Wide field visibility, visualization of nooks and corners by an endoscope could contribute to better clinical control of the disease in these patients that cannot be accessed by the operating microscope.  Methods: This was a descriptive cross-sectional study, done in Kathmandu Medical College from January to June 2017. Thirty two patients were included in the study. Data collection was done by convenient sampling. Statistical analysis was done by Chi square test and Fisher Exact test, P value of <0.005 was considered statistically significant. Results: The study revealed that exposure benefit with an endoscope in canal wall down mastoid surgery was significantly better than with a microscope (P value of 0.034). The level of complete clearance and level of difficulty in cleaning with the help of a microscope compared to endoscope did not show a significant difference with P value of 0.288 and 0.652 obtained by Fisher extract test respectively. After microscopic removal of materials from the mastoid cavity, 22 (68.8%) which is more than half of cases had remaining materials in the cavity which was removed by endoscope completely. Conclusions: Outcome will make the ENT surgeons aware of use of endoscopy in post mastoid follow up cases to give better results and make the surgeon much more successful in his/her endeavor to eradicate the disease.

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>

Application of amniotic membrane for covering mastoid cavity in canal wall down mastoidectomy

2019 ◽  
Vol 129 (6) ◽  
pp. 1453-1457 ◽  
Author(s):  
Mohammad Faramarzi ◽  
Reza Kaboodkhani ◽  
Sareh Roosta ◽  
Negar Azarpira ◽  
Mahmood Shishegar ◽  
...  
Keyword(s):  
Amniotic Membrane ◽  
Mastoid Cavity ◽  
Canal Wall ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy

scholarly journals Management of Benign Middle Ear Tumors: A Series of 7 Cases

2017 ◽  
Vol 96 (10-11) ◽  
pp. 426-432
Author(s):  
Z. Jason Qian ◽  
Amy M. Coffey ◽  
Kathleen M. O'Toole ◽  
Anil K. Lalwani
Keyword(s):  
Surgical Management ◽  
Middle Ear ◽  
Ossicular Chain ◽  
Clinical Findings ◽  
Mastoid Cavity ◽  
Canal Wall ◽  
Tumor Excision ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy ◽  
Rare Group

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.

scholarly journals Mastoidektomi Revisi pada Otitis Media Supuratif Kronik Tipe Bahaya

2015 ◽  
Vol 4 (3) ◽  
Author(s):  
Jacky Munilson ◽  
Tuti Nelvia
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Chronic Suppurative Otitis Media ◽  
Canal Wall ◽  
Suppurative Otitis Media ◽  
Canal Wall Down ◽  
Mastoid Surgery ◽  
Air Cells ◽  
Mastoid Operation

Abstrak Operasi mastoid berkembang sebagai penanganan terhadap Otitis Media Supuratif Kronik (OMSK). Mastoidektomi revisi dilakukan bila tujuan operasi pertama tidak tercapai. Kegagalan operasi mastoid bisa disebabkan oleh berbagai hal, diantaranya penanganan air cell yang tidak adekuat, facial ridge yang tinggi, kegagalan membuang semua kolesteatom, meatoplasti yang tidak adekuat dan ketidakpatuhan pasien untuk kontrol setelah operasi. Operasi mastoid revisi biasanya lebih sulit dan berbahaya karena anatomi telinga tengah menjadi tidak jelas, landmark dapat hilang dan struktur berbahaya sudah terpapar. Dilaporkan satu kasus operasi mastoid revisi pada seorang laki-laki berumur 25 tahun, yang ditatalaksana dengan timpanomastoidektomi dinding runtuh.Kata kunci: otitis media supuratif kronik, mastoidektomi revisi, kolesteatom, meatoplasti Abstract Surgery of the mastoid developed as a treatment for chronic suppurative otitis media. Revision mastoid surgery done if the aim of first surgery not achieved. Failure of  mastoid operation may caused by many things, including handling of air cells are not adequate, high facial ridge,  failure to remove all cholestetoma  meatoplasty in adequate and non adherence of patient to control after surgery. Revision  mastoid surgery is usually more difficult and dangerous, because anatomy of the middle ear may be altered, some of the important landmarks can be loss and dangerous  structure has been exposed. It was reported one case revision mastoid surgery in a man aged 25 years old, management with canal wall down tympanomastoidectomy.Keywords: chronic suppurative otitis media, revision mastoidectomy, cholesteatoma, meatoplasty

scholarly journals Characteristic of Intratemporal Complication in Chronic Suppurative Otitis Media Patient with and without Cholesteatoma at Hasan Sadikin General Hospital Bandung

2020 ◽  
Vol 2 (6) ◽  
Author(s):  
Ilman F Martanegara ◽  
Bambang Purwanto ◽  
Shinta F Boesoirie
Keyword(s):  
General Hospital ◽  
Otitis Media ◽  
Chronic Suppurative Otitis Media ◽  
Canal Wall ◽  
Suppurative Otitis Media ◽  
Canal Wall Down

Otitis media supuratif kronis (OMSK) merupakan penyakit telinga umum di negara-negara berkembang. Kasus OMSK dengan kolesteatoma sering disebut sebagai tipe bahaya. Tujuan penelitian ini untuk mengetahui karakteristik komplikasi intratemporal pada pasien OMSK dengan dan tanpa kolesteatoma di Poliklinik Telinga Hidung Tenggorok Bedah Kepala Leher (THT-KL) Rumah Sakit Hasan Sadikin (RSHS) Bandung. Penelitian ini merupakan penelitian deskriptif retrospektif dari pasien yang datang ke poliklinik THT-KL RSHS Bandung periode 2014-2017. Diagnosis ditegakkan berdasarkan anamnesis, pemeriksaan fisik, dan penunjang radiologi. Didapatkan 791 kasus baru OMSK; pria (51,20%), sebanyak 30,59% kasus berada di rentang usia 21-30. Gejala dan tanda klinis yang paling  sering terjadi adalah telinga berair (70,92) %, tipe gangguan dengar yang paling sering terjadi adalah tuli konduktif (83,94%).  Pada proyeksi foto Schuller, 64,72 % menunjukkan gambaran mastoiditis kronis dengan kolesteatoma.  Dari hasil kultur dijumpai 19,97 % kasus disebabkan oleh Pseudomonas aeroginosa. Komplikasi mastoiditis didapatkan pada 86,34%. Pada operasi Canal Wall Down ditemukan kolesteatoma pada 60, 42% kasus. Komplikasi terbanyak intratemporal pasien OMSK dengan dan tanpa kolesteatoma adalah mastoiditis kronis. Simpulan, komplikasi terbanyak intratemporal pasien OMSK dengan dan tanpa kolesteatoma adalah mastoiditis kronis. Profil penderita OMSK tipe bahaya dengan komplikasi intratemporal  di RSUP Dr. Hasan Sadikin masih tinggi.   Kata kunci: karakteristik; kolesteatoma; mastoiditis kronis; otitis media supuratif kronik

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