Cholesteatoma Causing a Horizontal Semicircular Canal Fistula

Horizontal canal fistulas are not uncommon in patients with cholesteatoma. Patients with canal wall down cavities and exposed horizontal canal fistulas develop significant dizziness with wind or suction exposure. Obliteration of mastoid cavities in patients with exposed fistulas can be challenging. We describe a patient with horizontal canal fistula and chronic dizziness from wind exposure who underwent successful mastoid cavity obliteration with preservation of hearing. Patients with horizontal canal fistulas in a canal wall down cavity can be managed with mastoid obliteration for relief of dizziness.

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Mastoid Obliteration Using Bioactive Glass—Our Experience

Annals of Otology and Neurotology ◽

10.1055/s-0041-1735414 ◽

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.

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

The Journal of Laryngology & Otology ◽

10.1017/s0022215120001139 ◽

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.

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Cholesteatoma surgery by open technique with reconstruction together with same session ossiculoplasty

The Egyptian Journal of Otolaryngology ◽

10.1186/s43163-021-00079-9 ◽

2021 ◽

Vol 37 (1) ◽

Author(s):

Mohammed Saad Hasaballah ◽

Peter Milad ◽

Ossama Mustafa Mady ◽

Ahmed Abdelmoneim Teaima

Keyword(s):

Complete Removal ◽

Mastoid Cavity ◽

Canal Wall ◽

Open Technique ◽

Viable Option ◽

Effective Option ◽

Canal Wall Down ◽

Canal Wall Down Mastoidectomy ◽

Cavity Obliteration ◽

Cholesteatoma Surgery

Abstract Background This study was designed to evaluate the effect of mastoid cavity obliteration with bone chips and reconstruction of canal wall with tragal cartilage after canal wall down tympanomastoidectomy with cartilage ossiculoplasty in the same session. Sixty-three patients with cholesteatoma underwent the technique mentioned above; patients were followed for 1 year postoperative. Results No cavity problems, median preoperative air bone gap was 32.86 ± 6.24 db, while the median postoperative air bone gap was 21.67 ± 5.99 db. Conclusions Canal wall down mastoidectomy with obliteration of mastoid cavity is an effective option for the complete removal of cholesteatoma and same session cartilage ossiculoplasty is a viable option.

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Combined conchal cartilage islet-periosteum and posterior based pedicled flap obliteration: a comparison with unobliterated mastoid cavities

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20204619 ◽

2020 ◽

Vol 6 (11) ◽

pp. 1991

Author(s):

Arindam Das ◽

Sandipta Mitra ◽

Sayan Hazra ◽

Arunabha Sengupta

Keyword(s):

Chronic Otitis Media ◽

Pedicled Flap ◽

Open Cavity ◽

Mastoid Cavity ◽

Volume Discharge ◽

Cavity Volume ◽

Canal Wall ◽

Conchal Cartilage ◽

Canal Wall Down ◽

Cavity Obliteration

Background: Aim of the study was to compare the outcomes of a new technique of mastoid cavity obliteration with open mastoid cavity.Methods: 90 patients diagnosed with chronic otitis media (active squamosal variety) and planned to undergo surgery between 2016-2018 were randomly assigned into two groups of 45 patients. One group underwent canal wall down matoidectomy followed by cavity obliteration with posteriorly based vascularised flap with mastoid cortex periosteum plus conchal cartilage composite graft and the other underwent the same surgery but without any obliteration. The two groups were compared in terms of cavity volume, discharge, epithelisation, wax formation, subjective sensation of vertigo and post-operative air-bone gap at 1 year.Results: Cavity obliteration in post-canal wall down setting significantly reduced the post-operative cavity volume and need for cavity debridement with better epithelisation, less incidence of discharge, vertigo on caloric stimulation when compared to open cavity. The post-operative air-bone gap in obliterated cavities was better but not statistically significant.Conclusion: Cavity obliteration has definite advantages over open cavity in terms of healing but no significant differences in long-term audiological outcomes.

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The Efficacy of Mastoid Cavity Obliteration by Conchal Cartilage in Canal Wall Down Mastoidectomy

Journal of Otolaryngology Research ◽

10.18875/2638-3616.1.103 ◽

2018 ◽

Vol 1 (1) ◽

Author(s):

Al-Tayyar M ◽

Baban M ◽

Khdhayer A ◽

Najeeb R ◽

Othman S

Keyword(s):

Mastoid Cavity ◽

Canal Wall ◽

Conchal Cartilage ◽

Canal Wall Down ◽

Canal Wall Down Mastoidectomy ◽

Cavity Obliteration

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Mastoid cavity obliteration with bone dust: a retrospective study of 34 cases

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20213899 ◽

2021 ◽

Vol 7 (10) ◽

pp. 1644

Author(s):

Meenesh Juvekar ◽

Baisali Sarkar

Keyword(s):

Otitis Media ◽

Mastoid Cavity ◽

Canal Wall ◽

Radical Mastoidectomy ◽

Ossicular Reconstruction ◽

Modified Radical Mastoidectomy ◽

Canal Wall Down ◽

Cavity Obliteration ◽

Common Cavity

Background: Chronic suppurative otitis media leads to ear discharge with hearing loss with squamosal type often presents with cholesteatoma and mainstay of treatment is surgical. Modified radical mastoidectomy is the ideal surgical option in these cases but it results in open mastoid cavity formation with certain common cavity problems. This study done to find the results of mastoid cavity obliteration with autologous bone dust and how this technique is effective in avoiding long term cavity problems and assists in ossiculoplasty.Methods: This is a retrospective observational study done in a tertiary care hospital. Patients presented with squamosal type of chronic otitis media were operated for a canal wall down modified radical mastoidectomy.The mastoid cavity was obliterated using bone dust. A follow up of the patients was done and the healing of the cavity with the hearing result assessed.Results: The study includes total of 34 patients. 58.82% were male and 41.18% were female. All patients underwent canal wall down modified radical mastoidectomy and obliteration of the mastoid cavity was done with bone dust. The common cavity problems of discharge, debris were markedly reduced in an obliterated cavity with better healing of the cavity. The middle ear aeration was maintained assisting the ossicular reconstruction.Conclusions: This study showed that mastoid cavity obliteration with bone dust offers significant long term benefits in providing dry, well epithelized cavity at the same time assisting in ossicular reconstruction.

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Outcome of Post-Operative Mastoid Cavity Obliteration with Autologous Adipose Tissue

Bengal Journal of Otolaryngology and Head Neck Surgery ◽

10.47210/bjohns.2020.v28i2.331 ◽

2020 ◽

Vol 28 (2) ◽

pp. 138-143

Author(s):

Rabi Hembrom ◽

Satadal Mondal ◽

Indranil Sen ◽

Amit Chakrabarti ◽

Rupam Sinha ◽

...

Keyword(s):

Adipose Tissue ◽

Randomized Study ◽

Chronic Otitis Media ◽

Mastoid Cavity ◽

Canal Wall ◽

Group A ◽

Canal Wall Down ◽

Canal Wall Down Mastoidectomy ◽

Group B ◽

Cavity Obliteration

Introduction Mastoid operations have been in practice for over four centuries for suppurative conditions of the ear. Intact canal wall mastoidectomy has the advantage of better functional results while canal wall down mastoidectomy offers excellent exposure for disease eradication and post operative monitoring but is associated with significant cavity problems. In order to overcome the problems associated with canal wall down procedure while retaining its advantages the concept of mastoid cavity obliteration was introduced. This study analysed the outcomes of mastoid cavity obliteration and to assess the outcomes of mastoid cavity obliteration with autologous adipose tissue. Materials and Methods A prospective, experimental, randomized study was conducted over a period of 18 months among patients presenting with active squamous variety of Chronic Otitis Media. The patients were randomly allocated to two groups, A and B. Both groups underwent canal wall down Mastoidectomy followed by obliteration with autologous adipose tissue in Group B . Results In group A, the mean duration required for complete epithelialization was 10.8 weeks. In group B, the average time taken for complete epithelialization was 5.6 weeks. All cases had their graft intact at the end of 12 weeks. Debris was present in group A for a mean duration of 9.47 weeks. In group B, debris was found for a mean duration of 3.33 weeks. Patients from group A complained of discharge from their ears for a mean duration of 7.47 weeks. In group B the same symptom persisted over 3.33 weeks. Conclusion Cavity problems encountered is considerably less in the group obliterated with adipose tissue.

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Comparative Evaluation of Mastoid Cavity Obliteration by Vascularised Temporalis Myofascial Flap and Deep Temporal Fascial-Periosteal Flap in Canal Wall Down Mastoidectomy

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2016/21490.9121 ◽

2016 ◽

Author(s):

Navjot Kaur

Keyword(s):

Comparative Evaluation ◽

Mastoid Cavity ◽

Canal Wall ◽

Periosteal Flap ◽

Canal Wall Down ◽

Canal Wall Down Mastoidectomy ◽

Temporalis Myofascial Flap ◽

Cavity Obliteration

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Modified Canal Wall Down Mastoidectomy Without Meatoplasty

Korean Journal of Otorhinolaryngology - Head and Neck Surgery ◽

10.3342/kjorl-hns.2021.00850 ◽

2021 ◽

Vol 64 (12) ◽

pp. 965-970

Author(s):

You Young An ◽

Jong Dae Lee

Keyword(s):

Surgical Procedures ◽

Dead Space ◽

Mastoid Cavity ◽

Canal Wall ◽

Mastoid Obliteration ◽

Advantages And Disadvantages ◽

Retraction Pockets ◽

Canal Wall Down ◽

Canal Wall Down Mastoidectomy ◽

Canal Wall Up

It is important to decide which procedure to employ between canal wall up mastoidectomy and canal wall down mastoidectomy (CWDM) as each procedure has its own advantages and disadvantages. To combine the advantages and compensate the disadvantages of each procedure, various methods and approaches have been devised. Mastoid and epitympanic obliteration, which minimizes the dead space in the mastoid cavity, was previously known to prevent the occurrence of retraction pockets. We performed mastoid and epitympanic obliteration also to prevent the occurrence of cavity problems without meatoplasty. Here we describe the surgical procedures for modified CWDM without meatoplasty and mastoid obliteration using autologous materials.

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