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>

scholarly journals Chronic Suppurative Otitis Media Atticoantral- Type Undergone Canal Wall Down Mastoidectomy in a Peripheral Government Hospital of Nepal

2013 ◽  
Vol 52 (192) ◽  
Author(s):  
Dhundi Raj Paudel
Keyword(s):  
Otitis Media ◽  
Chronic Suppurative Otitis Media ◽  
Canal Wall ◽  
Suppurative Otitis Media ◽  
Hearing Ability ◽  
Peripheral Hospital ◽  
Operative Evaluation ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy ◽  
Operative Assessment

Introduction: Chronic suppurative otitis media is a severe type of chronic ear infection which is quite common in all geographical situations of Nepal. The mainstay of treatment of this disease is surgery, preferably of canal down method. The objective of the study was to identify the common presentation(s) and the clinical and operative finding(s) in patients with chronic suppurative otitis media attico-antral type and evaluation of efficacy of canal-wall down mastoidectomy in the achievement of dry ear and change in hearing in a setting of a peripheral hospital of Nepal in terms of subjectivity. Per-operative evaluation of mastoid cavities in terms of types of pathologies and post- operative assessment of ears in terms of achieving a dryness and change in hearing ability was carried out in the ENT Department, Bharatpur Hospital , Chitwan, Nepal. Study was done from January 2005 to December 2010. Methods: Seventy three patients with chronic suppurative otitis media atticoantral- type were evaluated preoperatively in terms of gross pathologies. Postoperatively, patients were subjectively evaluated twice in six months in reference to persistent ear discharge and change in hearing ability. Results: By six months of surgery, 75% of the patients had no discharge. Fifty two patients did not experience any change in hearing ability. Only 16% experienced betterment in hearing while 19% had diminution in hearing. Conclusions: Canal wall down mastoidectomies are very effective in controlling otorrhoea and complications related to chronic suppurative otitis media attico-antral type.  Keywords: Chronic suppurative otitis media attico-antral (CSOM-AA) type; CWD masoidectomy; CWU mastoidectomy; ear cavity.    

scholarly journals Intraoperative Findings during Canal Wall Down Mastoidectomy in Children

1970 ◽  
Vol 31 (3) ◽  
pp. 184-187
Author(s):  
S Shrestha ◽  
P Kafle
Keyword(s):  
Otitis Media ◽  
Ossicular Chain ◽  
Chain Condition ◽  
Chronic Suppurative Otitis Media ◽  
Canal Wall ◽  
Suppurative Otitis Media ◽  
Bony Landmarks ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy ◽  
Operative Findings

Objective: The main objective of this study is to assess the intraoperative finding during canal wall down mastoidectomy in paediatric patients undergoing surgery for unsafe type of chronic suppurative otitis media (CSOM) attending ENT OPD of Kathmandu Medical College. Materials and Methods: Fifty patients of age group 4 to 13 years who were suffering from unsafe type of CSOM with or without cholesteatoma were taken for the study. The study period was two years from April 2007 to March 2009. The operative findings like extent of cholesteatoma in different location of middle ear cleft, mastoid bony landmarks, and ossicular chain condition and otogenic complication were identified during canal wall down mastoidectomy. Result: Of the 50 patients 32 (64%) were boys and 18(36%) were girls. The age ranged from 4 years to 13 years. Majority of patients had cholesteatoma with granulation diseases (72%) followed by granulation diseases (16%). Involvement of disease in attic, aditus, antrum and mesotympanum were found to be high in majority of cases (82%) with high percentage of necrosis of incus (56%). Conclusion: The primary disease found in patients undergoing canal wall down mastoidectomy (CWDM) was cholesteatoma combined with granulation in72%, granulation in 16% and cholesteatoma in12%. Key words: Canal Wall Down; ENT; Mastoidectomy; Chronic Suppurative Otitis Media (CSOM) DOI: http://dx.doi.org/10.3126/jnps.v31i3.5357 J Nep Paedtr Soc 2011;31(3):184-187

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

scholarly journals Day-case management of chronic suppurative otitis media with cholesteatoma with canal wall down technique surgery: long-term follow-up

2017 ◽  
Vol 7 (2) ◽  
Author(s):  
Giovanni Ralli ◽  
Giuseppe Nola ◽  
Alberto Taglioni ◽  
Michele Grasso ◽  
Massimo Ralli
Keyword(s):  
Otitis Media ◽  
Day Surgery ◽  
Chronic Suppurative Otitis Media ◽  
Canal Wall ◽  
Day Case ◽  
Suppurative Otitis Media ◽  
Preoperative Selection ◽  
Canal Wall Down

The overall number of day-case otologic surgery cases is increasing; however, there is limited experience about performing canal wall down tympanoplasty in patients with chronic suppurative otitis media with cholesteatoma in this setting. The objective of this study was to assess the success of this technique as daycase surgery in terms of results and complications over an 8-year follow up period. We included in this study 42 patients undergoing canal wall down technique tympanoplasty surgery for chronic suppurative otitis media with cholesteatoma performed as day cases during a 2-year period. 30 cases (71.4%) were discharged on the day of surgery, whereas 12 cases (28.6%) were hospitalized and discharged the day after. The principal reasons for failure of discharge on the day of surgery were asthenia (6 cases), vertigo and asthenia (4 cases), undetermined (2 cases). Based on our experience, with a proper preoperative selection, assessment and screening of the patients, mastoidectomy with timpanoplasty for chronic suppurative otitis media with cholesteatoma can be carried out in a day surgery setting with no significant effects on effectiveness of surgery, post-operative symptoms and relapse of disease even in the long term.

Tympano–cartilago–stapediopexy: a method to improve hearing in open technique tympanoplasty

1990 ◽  
Vol 104 (12) ◽  
pp. 942-944 ◽  
Author(s):  
H. M. Moustafa ◽  
M. A. Khalifa
Keyword(s):  
Otitis Media ◽  
The Other ◽  
Chronic Suppurative Otitis Media ◽  
Canal Wall ◽  
Open Technique ◽  
Temporalis Fascia ◽  
Suppurative Otitis Media ◽  
Type Iii ◽  
Canal Wall Down

AbstractCanal wall-down technique tympanoplasty was indicated in about 41 per cent of our cases with chronic suppurative otitis media. In this series done during the last four years, of 576 tympanoplasties, 240 cases needed type III tympanoplasty. In 145 cases, myringostapediopexy was carried out using temporalis fascia grafting over the head of the stapes. Tympano-cartilago-stapediopexy was performed in the other 95 cases by using tragal cartilage and perichondrium over the stapes. A comparison between the results of both methods of grafting is discussed. Improvement in hearing was achieved after tympano-cartilago-stapediopexy. This method proved to be suitable for those cases which need open technique tympanoplasty.

scholarly journals Surgical Outcomes of Revision Operation for Non-Cholesteatomatous Chronic Otitis Media

2021 ◽  
Vol 64 (5) ◽  
pp. 304-309
Author(s):  
Juho Han ◽  
Jisoo Lee ◽  
Sung Kwang Hong ◽  
Hyo Jeong Lee ◽  
Hyung-Jong Kim
Keyword(s):  
Otitis Media ◽  
Surgical Outcomes ◽  
Chronic Otitis Media ◽  
Surgical Approaches ◽  
Middle Ear Surgery ◽  
Canal Wall ◽  
Revision Operation ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy ◽  
Better Than

Background and Objectives The aim of this study was to investigate the surgical outcomes of revision operation due to recurrence of non-cholesteatomatous chronic otitis media (COM) surgery cases.Subjects and Method From 1989 to 2018, 5197 cases of COM surgery were performed at Kangdong and Hallym University Sacred Heart Hospital. Among them, clinical data of 297 subjects who had undergone revision tympanoplasty and/or mastoidectomy for recurrent noncholesteatomatous COM were retrospectively collected from computerized database of middle ear surgery (Korean Otological Society program 2005). Each case was categorized by surgical approaches into canal wall down mastoidectomy (CWDM), canal wall up mastoidectomy (CWUM), or tympanoplasty only groups.Results Tympanoplasty only was performed in 170 cases, CWDM in 74 cases, and CMUM in 53 cases. Postoperative perforation occurred in 9.4% of total cases, and less frequently in CMDM compared with tympanoplasty only (<i>p</i>=0.023), and CMUM (<i>p</i>=0.049), respectively, whereas no differences between tympanoplasty only and CMUM (<i>p</i>=0.930) were found. Postoperative infection rate was 1.0% and did not show any differences among the groups. Postoperative successful hearing was obtained in 66.7% of total cases, and the success rate of tympanoplasty only was better than that of CMDM (<i>p</i>=0.001), and CMUM (<i>p</i>=0.011). And, that of CMUM was better than that of CMDM (<i>p</i>=0.011).Conclusion The results showed that postoperative perforation occurred less frequently in CMDM than in tympanoplasty only and in CWUM; successful hearing was achieved more frequently in tympanoplasty alone than in the other surgical approaches in recurrent non-cholesteatomatous COM.

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.

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