Surgical Treatment of Chronic Middle Ear Disease: II. Canal Wall Up and Canal Wall Down Procedures

1987 ◽  
Vol 104 (5-6) ◽  
pp. 487-494 ◽  
Author(s):  
Tauno Palva
Keyword(s):  
Surgical Treatment ◽  
Middle Ear ◽  
Canal Wall ◽  
Canal Wall Down ◽  
Middle Ear Disease ◽  
Canal Wall Up

scholarly journals Correlation between functional outcome and the SAMEO-ATO framework

2021 ◽  
Author(s):  
Vito Pontillo ◽  
Marialessia Damiani ◽  
Giusi Graziano ◽  
Nicola Quaranta
Keyword(s):  
Functional Outcome ◽  
Middle Ear ◽  
Petrous Bone ◽  
Canal Wall ◽  
Hearing Results ◽  
Tertiary Referral Center ◽  
Ossicular Reconstruction ◽  
Canal Wall Down ◽  
Mastoid Surgery ◽  
Canal Wall Up

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.

scholarly journals Canal wall down versus canal wall up surgeries in the treatment of middle ear cholesteatoma

2019 ◽  
Vol 49 (5) ◽  
pp. 1426-1432
Author(s):  
Recep KARAMERT ◽  
Fakih Cihat ERAVCI ◽  
Süleyman CEBECİ ◽  
Mehmet DÜZLÜ ◽  
Mehmet Ekrem ZORLU ◽  
...  
Keyword(s):  
Middle Ear ◽  
Canal Wall ◽  
Middle Ear Cholesteatoma ◽  
Canal Wall Down ◽  
Canal Wall Up

Acoustic Mechanisms

1998 ◽  
Vol 118 (6) ◽  
pp. 751-761 ◽  
Author(s):  
KENNETH R. WHITTEMORE ◽  
SAUMIL N. MERCHANT ◽  
JOHN J. ROSOWSKI
Keyword(s):  
Middle Ear ◽  
Sound Transmission ◽  
Canal Wall ◽  
Air Space ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy ◽  
Temporal Bones ◽  
Head Neck ◽  
Canal Wall Up ◽  
Space Volume

The contribution of the middle ear air spaces to sound transmission through the middle ear in canal wall-up and canal wall-down mastoidectomy was studied in human temporal bones by measurements of middle ear input impedance and sound pressure difference across the tympanic membrane for the frequency range 50 Hz to 5 kHz. These measurements indicate that, relative to canal wall-up procedures, canal wall-down mastoidectomy results in a 1 to 5 dB decrease in middle ear sound transmission below 1 kHz, a 0 to 10 dB increase between 1 and 3 kHz, and no change above 3 kHz. These results are consistent with those reported by Gyo et al. (Arch Otolaryngol Head Neck Surg 1986;112:1262-8), in which umbo displacement was used as a measure of sound transmission. A model analysis suggests that the reduction in sound transmission below 1 kHz can be explained by the smaller middle ear air space volume associated with the canal wall-down procedure. We conclude that as long as the middle ear air space is aerated and has a volume greater than 0.7 ml, canal wall-down mastoidectomy should generally cause less than 10 dB changes in middle ear sound transmission relative to the canal wall-up procedure. (Otolaryngol Head Neck Surg 1998;118:751-61.)

scholarly journals Functional outcomes of middle ear cholesteatoma surgery

2018 ◽  
Vol 71 (3-4) ◽  
pp. 109-113
Author(s):  
Dalibor Vranjes ◽  
Sanja Spiric ◽  
Slobodan Spremo ◽  
Dmitar Travar ◽  
Predrag Spiric ◽  
...  
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Lower Incidence ◽  
Functional Outcomes ◽  
Pure Tone ◽  
Chronic Otitis Media ◽  
Pure Tone Audiometry ◽  
Canal Wall ◽  
Canal Wall Down ◽  
Canal Wall Up

Introduction. Chronic otitis media is defined as a persistent inflammation of the middle ear with signs of an infection lasting for three months or longer. Chronic otitis media may occur either with or without cholesteatoma. For both types of conditions, surgical treatment with closed canal wall-up or open canal wall-down techniques of tympanoplasty are considered. Our aim was to evaluate functional outcomes in two groups of patients (chronic otitis media with cholesteatoma and chronic otitis media without cholesteatoma) treated with various tympanoplasty techniques. Material and Methods. This retrospective study included 100 patients who underwent canal wall-down and canal wall-up tympanoplasty for the treatment of chronic otitis media with cholesteatoma and chronic otitis media without cholesteatoma from 2015 to 2016. All study patients underwent routine clinical and audiometric examinations. The study evaluated preoperative and postoperative functional results (evaluation of pure-tone audiogram screening). Results. A statistically significant lower incidence (p < 0.05) of postoperative air-bone gap < 20 decibels was established in patients with chronic otitis media with cholesteatoma, but there were no statistically significant differences between the two groups. There was a statistically lower incidence (p < 0.05) of patients with postoperative pure tone audiometry < 40 decibels in patients with chronic otitis media with cholesteatoma, but the difference between the two groups was not statistically significant. When analyzing the mean postoperative pure tone audiometry and air-bone gap in the study patients, canal wall-up tympanoplasty was found to be statistically more effective (p < 0.05). Conclusion. Various pathomorphological and pathophysiological changes in the middle ear, presence of extensively different forms of cholesteatomas, the choice of surgical procedures and poor preoperative hearing are in direct correlation with postoperative hearing.

scholarly journals Outcomes of type III tympanoplasty: our experience

2020 ◽  
Vol 6 (2) ◽  
pp. 287
Author(s):  
Ravishankar C. ◽  
Ramya Bandadka
Keyword(s):  
Middle Ear ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Canal Wall ◽  
Type Iii ◽  
Hearing Gain ◽  
Middle Ear Prosthesis ◽  
Canal Wall Down ◽  
Middle Ear Cleft ◽  
Canal Wall Up

<p class="abstract"><strong>Background:</strong> Type III tympanoplasty involves complete disease clearance from middle ear cleft and retaining or improving the serviceable hearing by ossiculoplasty. Various auto and allografts have been used with variable outcomes. The objective of the study was to evaluate hearing improvement and healing of cavity in patients who underwent type III tympanoplasty.</p><p class="abstract"><strong>Methods:</strong> A retrospective chart review of 21 patients who underwent type III tympanoplasty at Bowring and Lady Curzon Hospital from January 2018 to December 2018 was done. In 7 patients autologous incus, 6 tragal cartilage and 8 teflon prosthesis was used for ossiculoplasty. Intra and postoperative events were assessed. Pure tone audiograms done after 3 and 6 months were compared.  </p><p class="abstract"><strong>Results:</strong> 15 patients who underwent canal wall down procedure (CWDP) had a mean hearing gain of 20.33 dB and 26.67 dB while in 5 patients of canal wall up procedure (CWUP) group mean hearing gain was 22.5 dB and 27.5 dB at 3 and 6 months after surgery respectively. Hearing gain was similar in both groups irrespective of the prosthesis used. Autologous materials were used in most of the CWUP with intact stapes and teflon prosthesis was used in majority of CWDP where only mobile stapes foot plate was present. Prosthesis extrusion was not encountered in any of our cases so far in this series.</p><p class="abstract"><strong>Conclusions:</strong> The post-operative hearing gain with autologous incus, tragal cartilage and teflon middle ear prosthesis are similar. Teflon prosthesis is an effective material for ossiculoplasty, especially useful when incus and stapes are absent while autologous incus or tragal cartilage are preferred in cases with intact stapes head.</p>

scholarly journals Middle ear aeration in staged canal wall up tympanoplasty combined with mastoid cortex plasty or bony mastoid obliteration

2016 ◽  
Vol 130 (S3) ◽  
pp. S24-S24
Author(s):  
Masahiro Komori ◽  
Naoaki Yanagihara ◽  
Jun Hyodo ◽  
Yasuyuki Hinohira ◽  
Ryosei Minoda ◽  
...  
Keyword(s):  
Middle Ear ◽  
Canal Wall ◽  
Mastoid Obliteration ◽  
Canal Wall Up
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