scholarly journals Outcome of intact canal wall mastoidectomy in limited attic cholesteatoma

Author(s):  
Rajeev Reddy

<p class="abstract"><strong>Background:</strong> Surgery for cholesteatoma has evolved over the years in terms of efficacy and patient compliance and better life. Intact canal wall technique is best in terms of normalization of the physiology of the ear along with eradication of disease. Hence this study is undertaken to evaluate a technique of intact canal wall mastoidectomy for limited attic cholesteatoma and to study practical considerations during surgery.</p><p class="abstract"><strong>Methods:</strong> Any person undergoing surgery for attic cholesteatoma has to be thoroughly examined during surgery and decision for doing a canal wall up (CWP) surgery will be taken on the operating table. The patients were regularly followed up and microscopic, otoendoscopic and audiological assessments done at regular intervals. Revision surgery was done only if there were signs of recidivism or if ossiculoplasty was planned for second stage or placement of prosthesis later was considered.  </p><p class="abstract"><strong>Results:</strong> Out of 100 cholesteatoma surgeries, 22 cases found suitable for the CWU technique. Only 1 out of 22 patients required revision surgery due to recurrence. Rest of the patients maintained healthy middle ear for more than a year. Prevention of medialization of attic cartilage piece was found to be a very important consideration.</p><p><strong>Conclusions:</strong> The CWU technique is a reliable method of management for limited attic cholesteatoma. Selection of subjects should be very meticulous. </p>

2011 ◽  
Vol 38 (2) ◽  
pp. 190-195 ◽  
Author(s):  
Kyung Tae Park ◽  
Jae-Jin Song ◽  
Sung Joong Moon ◽  
Jun Ho Lee ◽  
Sun O Chang ◽  
...  

Author(s):  
Vito Pontillo ◽  
Marialessia Damiani ◽  
Giusi Graziano ◽  
Nicola Quaranta

Abstract Purpose To evaluate the recently proposed SAMEO-ATO framework for middle ear and mastoid surgery, by correlating it with the functional outcome in a large cohort of patients operated for middle ear and mastoid cholesteatoma in a tertiary referral center. Methods We retrospectively included all surgeries for middle ear and mastoid cholesteatoma undergone in our Department between January 2009 and December 2014, by excluding revision surgeries, congenital and petrous bone cholesteatoma. All surgeries were classified according to the SAMEO-ATO framework. The post-operative air bone gap (ABG) was calculated and chosen as benchmark parameter for the correlation analysis. Results 282 consecutive surgeries for middle ear and mastoid cholesteatoma were released in the study period on a total of 273 patients, with a mean age of 41.2 years. All patients were followed for an average period of 55.3 months. 54% of patients underwent M2c mastoidectomy (Canal Wall Down, CWD), while the remaining underwent Canal Wall Up (CWU) procedures, being M1b2a mastoidectomy the most common one (33%). Mean pre-operative and post-operative ABGs were 29.2 and 23.5 dB, with a significant improvement (p < 0.0001). ‘Mastoidectomy’ and ‘Ossicular reconstruction’ parameters of SAMEO-ATO showed significant association with postoperative ABG, with smaller residual gaps for the classes Mx and On, and worse hearing results for M3a and Ox. Conclusion Our results show the utility of SAMEO-ATO framework, and in particular of ‘M’ (Mastoidectomy) and ‘O’ (Ossicular reconstruction) parameters, in predicting the hearing outcome.


2016 ◽  
Vol 130 (S3) ◽  
pp. S24-S24
Author(s):  
Masahiro Komori ◽  
Naoaki Yanagihara ◽  
Jun Hyodo ◽  
Yasuyuki Hinohira ◽  
Ryosei Minoda ◽  
...  

2019 ◽  
Vol 49 (5) ◽  
pp. 1426-1432
Author(s):  
Recep KARAMERT ◽  
Fakih Cihat ERAVCI ◽  
Süleyman CEBECİ ◽  
Mehmet DÜZLÜ ◽  
Mehmet Ekrem ZORLU ◽  
...  

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.


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