scholarly journals Hearing Outcomes According to the Types of Mastoidectomy: A Comparison between Canal Wall Up and Canal Wall Down Mastoidectomy

2010 ◽  
Vol 3 (4) ◽  
pp. 203 ◽  
Author(s):  
Min-Beom Kim ◽  
Jeesun Choi ◽  
Jae Kwon Lee ◽  
Ju-Yeon Park ◽  
Hosuk Chu ◽  
...  
Keyword(s):  
Canal Wall ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy ◽  
Hearing Outcomes ◽  
Canal Wall Up

Hearing Outcomes Following Type 3 Tympanoplasty With Stapes Columella Grafting in Canal Wall Down Mastoidectomy

2019 ◽  
Vol 128 (8) ◽  
pp. 736-741
Author(s):  
C. Burton Wood ◽  
Brendan P. O’Connell ◽  
Anne C. Lowery ◽  
Marc L. Bennett ◽  
George B. Wanna
Keyword(s):  
Care Center ◽  
Cohort Analysis ◽  
Tertiary Care ◽  
Canal Wall ◽  
Short Term ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy ◽  
Hearing Outcomes ◽  
Type 3

Objectives: To analyze hearing outcomes following Type 3 tympanoplasty with stapes columella grafting after canal wall down mastoidectomy and determine disease recurrence rates in patients undergoing this procedure. Methods: This retrospective cohort analysis examines patients undergoing Type 3 tympanoplasty with stapes columella grafting following canal wall down mastoidectomy for cholesteatoma at a tertiary care center from 2005 to 2015. 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: Nineteen patients met criteria for this study. Erosion of the otic capsule, posterior fossa plate, or tegmen was noted in 37% of cases, highlighting disease severity. Eighteen (95%) had undergone prior otologic surgery. Mean time to short-term follow-up was 6 ± 3 months. The average short-term ABG was 26 ± 11 dB HL; 26% achieved an ABG <20 dB, and 58% achieved an ABG <30 dB. Fifteen had follow-up at least 1 year postoperatively (mean = 33 ± 16 months). At longer-term follow-up, mean ABG was 25 ± 10 dB HL; 33% achieved an ABG <20 dB, while 66% achieved an ABG <30 dB. Hearing remained stable over time ( P = .52). At date of last clinical follow-up, only 1 (5%) patient had undergone revision for recurrent disease. Conclusion: In some patients undergoing canal wall down mastoidectomy for advanced or recurrent cholesteatoma, Type 3 tympanoplasty with stapes columella grafting yields marginal hearing benefit. This type of reconstruction is a viable option in this challenging patient cohort, particularly as it is associated with low rates of revision surgery.

scholarly journals Recidivous cholesteatoma: DWI MR after canal wall up and canal wall down mastoidectomy

2016 ◽  
Vol 117 (09) ◽  
pp. 515-520
Author(s):  
T. Bakaj ◽  
L. Bakaj Zbrozkova ◽  
R. Salzman ◽  
M. Tedla ◽  
I. Starek
Keyword(s):  
Canal Wall ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy ◽  
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.)

Canal wall down mastoidectomy with obliteration versus canal wall up mastoidectomy in primary cholesteatoma surgery

2019 ◽  
Vol 133 (12) ◽  
pp. 1074-1078 ◽  
Author(s):  
M D Wilkie ◽  
D Chudek ◽  
C J Webb ◽  
A Panarese ◽  
G Banhegyi
Keyword(s):  
Discharge Rate ◽  
Recidivism Rate ◽  
Canal Wall ◽  
Chi Square ◽  
Mastoid Obliteration ◽  
Recidivism Rates ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy ◽  
Canal Wall Up ◽  
Cholesteatoma Surgery

AbstractObjectiveThis study sought to compare disease recidivism rates between canal wall up mastoidectomy and a canal wall down with obliteration technique.MethodsPatients undergoing primary cholesteatoma surgery at our institution over a five-year period (2013–2017) using the aforementioned techniques were eligible for inclusion in the study. Rates of discharge and disease recidivism were analysed using chi-square statistics.ResultsA total of 104 ears (98 patients) were included. The mean follow-up period was 30 months (range, 12–52 months). A canal wall down with mastoid obliteration technique was performed in 55 cases and a canal wall up approach was performed in 49 cases. Disease recidivism rates were 7.3 per cent and 16.3 per cent in the canal wall down with mastoid obliteration and canal wall up groups respectively (p = 0.02), whilst discharge rates were similar (7.3 per cent and 10.2 per cent respectively).ConclusionOur direct comparative data suggest that canal wall down mastoidectomy with obliteration is superior to a canal wall up technique in primary cholesteatoma surgery, providing a lower recidivism rate combined with a low post-operative ear discharge rate.

scholarly journals A comparative study of hearing outcomes in canal wall up versus canal wall down mastoidectomy in our experience

2019 ◽  
Vol 5 (2) ◽  
pp. 472
Author(s):  
Poornima S. Bhat ◽  
G. Gandhi ◽  
K. Pradheep
Keyword(s):  
Hearing Loss ◽  
Conductive Hearing Loss ◽  
Pure Tone Audiometry ◽  
Canal Wall ◽  
Hearing Gain ◽  
Hearing Outcome ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy ◽  
Conductive Hearing ◽  
Canal Wall Up

<p class="abstract"><strong>Background:</strong> COM causes considerable morbidity with ear discharge, conductive hearing loss and complications. Ossicular reconstruction is a surgical procedure which intends to improve the quality of hearing and life in such patients. Comparison of the outcomes will help to determine the merits or demerits of a particular procedure.</p><p class="abstract"><strong>Methods:</strong> The study was conducted in the Department of ENT, VIMS, Bellary during the period from December 2010 to May 2012. All the patients with CSOM with ossicular erosion suggested by conductive hearing loss more than 40dB were included in the study. A detailed history taking, thorough clinical examination was done for these patients. Before and after the procedure pure tone audiometry was done to assess the hearing outcome. Post operatively PTA was done in 6<sup>th</sup> week, 3<sup>rd</sup> month, 6<sup>th</sup> month follow up. Hearing improvement was analysed according to the type of procedure. The data collected was tabulated and subjected to statistical analysis.  </p><p class="abstract"><strong>Results:</strong> This study compared the outcomes of hearing gain in canal wall up versus canal wall down mastoidectomy surgeries. Hearing gain was better in canal wall up mastoidectomy (18.36 dB) than canal wall down mastoidectomy surgeries.</p><p class="abstract"><strong>Conclusions:</strong> Hearing outcome was better in intact canal wall mastoidectomy than canal wall down mastoidectomy in our study.</p><p class="abstract"> </p>

A multivariate analysis of the factors predicting hearing outcome after surgery for cholesteatoma in children

2006 ◽  
Vol 120 (11) ◽  
pp. 908-913 ◽  
Author(s):  
N K Chadha ◽  
A Jardine ◽  
D Owens ◽  
S Gillett ◽  
P J Robinson ◽  
...  
Keyword(s):  
Canal Wall ◽  
Hearing Outcome ◽  
Cohort Differences ◽  
Canal Wall Down ◽  
Hearing Outcomes ◽  
Mastoid Surgery ◽  
Disease Free ◽  
Canal Wall Up ◽  
Air Conduction

Objective: To explore factors influencing hearing outcomes in children treated by canal wall up (CWU) and canal wall down (CWD) mastoid surgery.Methods: Retrospective cohort study including three units in Bristol and Bath, UK. Ninety consecutive children underwent cholesteatoma mastoid surgery, with the first procedure between 1998 and 2001; minimum follow up was three disease-free years.Results: The CWU and CWD cohorts significantly differed in pre-operative stage and hearing. After disease eradication, air conduction (AC) thresholds changed by +4.0 dB (95 per cent confidence intervals (95%CI) −2.0, 10.1) in the CWD group and −5.3 dB (95%CI −9.3, 1.3) in the CWU group (p=0.029). Using multiple linear regression to account for cohort differences, AC thresholds were increased by: pre-operative AC threshold (p<0.0001), initial ossicular stage (p=0.013), and CWD-surgery (p=0.005).Conclusion: Disease-free hearing was better with CWU-surgery, less initial ossicular damage, and better pre-operative hearing. Worse initial disease increased the likelihood of CWD surgery. Wider use of ossiculoplasty in the CWU cohort (51 per cent vs 5 per cent) may partially explain the superior results.

Synchronous ossiculoplasty with titanium prosthesis during canal wall down surgery for advanced cholesteatoma: anatomical and hearing outcomes

2011 ◽  
Vol 126 (2) ◽  
pp. 131-135 ◽  
Author(s):  
M Iseri ◽  
E Ustundag ◽  
A Ulubil ◽  
M Ozturk ◽  
O Bircan
Keyword(s):  
Bone Conduction ◽  
Functional Results ◽  
Ossicular Chain ◽  
Single Stage ◽  
Canal Wall ◽  
Ossicular Replacement ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy ◽  
The Mean ◽  
Hearing Outcomes

AbstractObjective:To analyse patients with cholesteatoma undergoing canal wall down mastoidectomy together with ossicular reconstruction with a titanium prosthesis, in order to identify factors associated with hearing outcomes.Study design:Retrospective review of 97 cases undergoing single-stage surgical management.Methods:All patients underwent canal wall down mastoidectomy. Kurz titanium ossicular prostheses were used for ossicular chain reconstruction. Pre-operative and post-operative air conduction and bone conduction hearing thresholds were obtained at 500, 1000, 2000 and 3000 Hz.Results:The mean pure tone average improved from 46.02 ± 14.54 dB pre-operatively to 29.32 ± 14.64 dB post-operatively, for both total and partial ossicular replacement prosthesis groups combined. The mean air–bone gap improved from 30.38 ± 11.12 dB pre-operatively to 15.62 ± 9.65 dB post-operatively, for both groups combined.Conclusion:Reconstruction with a titanium prosthesis offers good functional results when performed during canal wall down surgery for advanced cholesteatoma, as a single-stage procedure.

Sign in / Sign up

Export Citation Format

Share Document