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.

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
Keyword(s):  
Tympanic Membrane ◽  
Middle Ear ◽  
Mastoid Cavity ◽  
Canal Wall ◽  
Retraction Pocket ◽  
The Status ◽  
Tube Dysfunction ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy

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.

scholarly journals Hearing Status After Ossiculoplasty in Open Cavity Mastoidectomy

2020 ◽  
Vol 23 (2) ◽  
pp. 195-198
Author(s):  
Md Zakaria Sarker ◽  
DC Talukder ◽  
Khabir Uddin Patuary ◽  
Md Rafiqul Islam ◽  
Saif Rahman Khan ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Ossicular Chain ◽  
Ear Reconstruction ◽  
Canal Wall ◽  
Prospective Longitudinal Study ◽  
Hearing Gain ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy ◽  
Middle Ear Reconstruction ◽  
Prospective Longitudinal

To evaluate the hearing outcome in canal wall down mastoidectomy with middle ear reconstruction, prospective longitudinal study was done at National Institute of ENT, Dhaka from March 2015 to September 2016. Total 22 patients were included in the study undergoing canal wall down mastoidectomy with 6 months postoperative followup. Hearing outcomes were observed and compared with the preoperative hearing tests. Among the 22 patients 9 (39.1% of subjects) patients had hearing gain, 12 (52.2%) had hearing loss and 1 (4.3%) had no change in hearing postoperatively.Although disease clearance is the main objective in canal wall down mastoidectomy, hearing gain can be achieved if combined with ossiculoplasty and tympanoplasty. The hearing gain or loss depends upon the extension of disease and status of the ossicular chain. Most patients usually experience hearing loss more than the preoperative period due to removal of ossicle or ossicles for the sake of disease clearance. Bangladesh J Otorhinolaryngol; October 2017; 23(2): 195-198

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

Canal wall down mastoidectomy: causes of failure, pitfalls and their management

1995 ◽  
Vol 109 (7) ◽  
pp. 583-589 ◽  
Author(s):  
Sanjaya Bhatia ◽  
Sandeep Karmarkar ◽  
Giuseppe DeDonato ◽  
Cemil Mutlu ◽  
Abdelkader Taibah ◽  
...  
Keyword(s):  
Middle Ear ◽  
Revision Surgery ◽  
Tympanic Membrane Perforation ◽  
Canal Wall ◽  
Revision Procedure ◽  
Primary Procedure ◽  
Membrane Perforation ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy ◽  
Causes Of Failure

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.

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.

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.

Pseudo mastoid obliteration with conchal cartilage may be a safe alternative technique for cochlear implantation in canal wall down mastoidectomy with large meatoplasty

2020 ◽  
Vol 134 (6) ◽  
pp. 493-496
Author(s):  
C Carnevale ◽  
G Til-Pérez ◽  
D Arancibia-Tagle ◽  
M Tomás-Barberán ◽  
P Sarría-Echegaray
Keyword(s):  
Cochlear Implantation ◽  
Mastoid Cavity ◽  
Canal Wall ◽  
Mastoid Obliteration ◽  
Safe Alternative ◽  
Conchal Cartilage ◽  
External Canal ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy

AbstractObjectiveSafe cochlear implantation is challenging in patients with canal wall down mastoid cavities, and the presence of large meatoplasties increases the risk of external canal overclosure. This paper describes our results of obliteration of the mastoid cavity with conchal cartilage as an alternative procedure in cases of canal wall down mastoidectomy with very large meatoplasty.MethodsThe cases of seven patients with a canal wall down mastoidectomy cavity who underwent cochlear implantation were retrospectively reviewed. Post-operative complications were analysed. The mean follow-up duration was 4.5 years.ResultsThere was no hint of cholesteatoma recurrence and all patients have been free of symptoms during follow up. Only one patient showed cable extrusion six months after surgery, and implantation of the contralateral ear was needed.ConclusionPseudo-obliteration of the mastoid cavity with a cartilage multi-layered palisade reconstruction covering the electrode may be a safe alternative in selected patients with a large meatoplasty.

scholarly journals Hearing Benefit in Allograft Tympanoplasty Using Tutoplast Processed Malleus

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Anja Lieder ◽  
Wolfgang Issing
Keyword(s):  
Hearing Loss ◽  
Middle Ear ◽  
Conductive Hearing Loss ◽  
Canal Wall ◽  
Hearing Improvement ◽  
Safe Alternative ◽  
Hearing Thresholds ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy ◽  
Conductive Hearing

Objectives.Tutoplast processed human cadaveric ossicular allografts are a safe alternative for ossicular reconstruction where there is insufficient material suitable for autograft ossiculoplasty. We present a series of 7 consecutive cases showing excellent air-bone gap closure following canal-wall-down mastoidectomy for cholesteatoma and reconstruction of the middle ear using Tutoplast processed malleus.Patients and Methods.Tympanoplasty with Tutoplast processed malleus was performed in seven patients to reconstruct the middle ear following canal-wall-down mastoidectomy in a tertiary ENT centre.Main Outcome Measures.Hearing improvement and recurrence-free period were assessed. Pre-and postoperative audiograms were performed.Results.The average pre operative hearing loss was 50 ± 13 dB, with an air-bone gap of 33 ± 7 dB. Post operative audiograms at 25 months demonstrated hearing thresholds of 29 ± 10 dB, with an air-bone gap of 14 ± 6 dB. No prosthesis extrusion was observed, which compares favourably to other commercially available prostheses.Conclusions.Tutoplast processed allografts restore conductive hearing loss in patients undergoing mastoidectomy and provide an excellent alternative when there is insufficient material suitable for autograft ossiculoplasty.

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