scholarly journals Surgical and audiological outcome of canal wall down mastoidectomy in Sub Himalayan region: our experience

2017 ◽  
Vol 5 (10) ◽  
pp. 4426
Author(s):  
Kuldeep Thakur ◽  
Ajay Ahluwalia ◽  
Vikas Deep Gupta
Keyword(s):  
Hearing Threshold ◽  
Mastoid Cavity ◽  
Canal Wall ◽  
Type Iii ◽  
Type Iv ◽  
Post Surgery ◽  
Maximum Improvement ◽  
Group A ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy

Background: Pre-operative and post-operative hearing status and status of mastoid cavity were compared in patients undergoing canal wall down mastoidectomy (CWDM) with tympanoplasty.Methods: Forty-three patients who underwent surgery and completed their follow up post-surgery were included in the study. Nineteen patients underwent CWDM with type III tympanoplasty with PORP, 7 patients underwent CWDM with type III tympanoplasty without PORP and 17 patients underwent CWDM with type IV tympanoplasty with TORP.Results: Among enrolled patients, 21 patients were females and 22 patients were male. Right ear (29) was commonly involved than left ear (14). Hearing loss was predominant symptom followed by recurrent ear discharge and other symptoms. Patients underwent three types of surgeries, type III tympanoplasty with PORP (19/43), type III tympanoplasty without PORP (7/43) and type IV tympanoplasty with TORP (17/43) by using Teflon prosthesis.Conclusions: Thirty seven percent (16/43) of patients had hearing threshold <25 dB post-surgery with maximum improvement in group A 47% (9/19). Forty seven percent (20/43) patients had hearing threshold between 26-40 dB with maximum improvement in group B 43% (3/7). Twelve percent (5/43) patients had hearing threshold between 41-60dB with almost equal improvement in all three groups. Five percent (2/43) of patients had >60dB hearing threshold, all belonging to group C. Anatomical results were assessed by examining the mastoid cavity showing 95%, 72%, 70% patients in group A, B and C had well epithelialized cavity.

scholarly journals Acetic Acid Instillation after Canal Wall Down Mastoidectomy

2015 ◽  
Vol 23 (3) ◽  
pp. 104-108
Author(s):  
Hamsa Shetty ◽  
Gangadhara K S
Keyword(s):  
Acetic Acid ◽  
Granulation Tissue ◽  
Mastoid Cavity ◽  
Canal Wall ◽  
Radical Mastoidectomy ◽  
Modified Radical Mastoidectomy ◽  
Group A ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy ◽  
Group B

Introduction: Persistent otorrhoea and granulation tissue in the mastoid cavity are common post-operative complications of Canal Wall Down Mastoidectomy. In order to avoid the same and to achieve a dry cavity instillation of acetic acid into the mastoid cavity during the post operative period is common practice. Materials and Methods In this study we assessed the results of 4% acetic acid instillation in varying quantity and frequency, in the ears after modified radical mastoidectomy. 40 Patients of chronic suppurative otitis media (atticoantral) / cholesteatoma, who underwent modified radical mastoidectomy during one and a half year period, were included in the study. The patients were divided into two groups; Group A with 30 patients and Group B with 10 patients, by simple randomization method. Group A patients were asked to instill 4% acetic acid approximately 10 to 12 drops (generously) into the mastoid cavity thrice a day for  8 weeks and were followed up every week.  10 patients  of Group B were asked to instill the same preparation only once weekly and followed up for the next 12 weeks.   Results: In Group A, dry mastoid cavity was achieved remarkably faster within six to eight weeks and in all the 30 patients. In Group B the results were delayed by up to 4 to 6 weeks in comparison to the Group A patients. Conclusion:             Though acetic acid instillation is known to help in achieving a dry cavity but a slightly higher concentration (4% acetic acid) used more frequently is highly effective in rendering dry cavity much earlier without proliferation of granulation tissue. 

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

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.

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 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 Outcomes of Canal Wall Down Mastoidectomy following Type III Tympanoplasty

2021 ◽  
Vol 27 (2) ◽  
pp. 145-151
Author(s):  
Shoukat Ali ◽  
SM Masudul Alam ◽  
KM Nurul Alam ◽  
KM Mamun Morshed ◽  
Sirajul Islam Mahfuz ◽  
...  
Keyword(s):  
Care Center ◽  
Demographic Data ◽  
Tertiary Care ◽  
Canal Wall ◽  
Short Term ◽  
Recurrence Rates ◽  
Type Iii ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy

Objectives: To see the hearing outcomes following Type III tympanoplasty with stapes columella grafting after canal wall down mastoidectomy and find out the recurrence rates in patients undergoing this procedure. Methods: This prospective observational study includes 120 cases undergoing Type III tympanoplasty with stapes columella grafting following canal wall down mastoidectomy for cholesteatoma at a tertiary care center from 2018 to 2020. Patient charts were reviewed for demographic data, diagnosis, and operative details. Patients were included in statistical analysis if they were found to have undergone the aforementioned procedure. Evaluation of hearing improvement was made by comparing preoperative air-bone gap (ABG) and ABG at follow-up at 6 months and 1 year postoperatively. Results: One hundred and twenty patients were included for this study. Erosion of the otic capsule, posterior fossa plate, or tegmen was noted in 20% of cases, highlighting disease severity. One hundred and two (85%) had undergone prior otologic surgery. Mean time to short-term follow-up was 6 ± 3 months. The average short-term ABG was 25 ± 12 dB HL; 36% achieved an ABG <20 dB and thirteen had follow-up at least 1 year postoperatively (mean = 33 ± 16 months). At longer-term follow-up, mean ABG was 24 ± 11 dB HL. Hearing remained stable over time (P = .26). Conclusion: In some patients undergoing canal wall down mastoidectomy for advanced or recurrent cholesteatoma, Type III tympanoplasty with stapes columella grafting yields marginal hearing benefit. Bangladesh J Otorhinolaryngol 2021; 27(2): 145-151

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.

scholarly journals Comparison of Pre and Postoperative Hearing Results after Cartilage Augmentation Type III Tympanoplasty

1970 ◽  
Vol 1 (2) ◽  
pp. 3-5
Author(s):  
BL Shrestha ◽  
H Bhattarai ◽  
CL Bhusai
Keyword(s):  
Canal Wall ◽  
Hearing Results ◽  
Type Iii ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy ◽  
Head Neck

Keywords: Air bone gap; chronic media (squamous); canal wall down mastoidectomy; cartilage augmentation type III tympanoplastyDOI: 10.3126/njenthns.v1i2.4752 Nepalese J ENT Head Neck Surg Vol.1 No.2 (2010) p.3-5

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