Mastoid Obliteration with Silicone Blocks after Canal Wall Down Mastoidectomy

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.

Download Full-text

Pseudo mastoid obliteration with conchal cartilage may be a safe alternative technique for cochlear implantation in canal wall down mastoidectomy with large meatoplasty

The Journal of Laryngology & Otology ◽

10.1017/s0022215120001139 ◽

2020 ◽

Vol 134 (6) ◽

pp. 493-496

Author(s):

C Carnevale ◽

G Til-Pérez ◽

D Arancibia-Tagle ◽

M Tomás-Barberán ◽

P Sarría-Echegaray

Keyword(s):

Cochlear Implantation ◽

Mastoid Cavity ◽

Canal Wall ◽

Mastoid Obliteration ◽

Safe Alternative ◽

Conchal Cartilage ◽

External Canal ◽

Canal Wall Down ◽

Canal Wall Down Mastoidectomy

AbstractObjectiveSafe cochlear implantation is challenging in patients with canal wall down mastoid cavities, and the presence of large meatoplasties increases the risk of external canal overclosure. This paper describes our results of obliteration of the mastoid cavity with conchal cartilage as an alternative procedure in cases of canal wall down mastoidectomy with very large meatoplasty.MethodsThe cases of seven patients with a canal wall down mastoidectomy cavity who underwent cochlear implantation were retrospectively reviewed. Post-operative complications were analysed. The mean follow-up duration was 4.5 years.ResultsThere was no hint of cholesteatoma recurrence and all patients have been free of symptoms during follow up. Only one patient showed cable extrusion six months after surgery, and implantation of the contralateral ear was needed.ConclusionPseudo-obliteration of the mastoid cavity with a cartilage multi-layered palisade reconstruction covering the electrode may be a safe alternative in selected patients with a large meatoplasty.

Download Full-text

Canal wall-down mastoidectomy with mastoid obliteration for pediatric cholesteatoma

Acta Oto-Laryngologica ◽

10.1080/00016480903094304 ◽

2009 ◽

pp. 1-4

Author(s):

Jiaqiang Sun ◽

Jingwu Sun ◽

Yanming Hu ◽

Qiuping Lv ◽

Yinfeng Wang ◽

...

Keyword(s):

Canal Wall ◽

Mastoid Obliteration ◽

Canal Wall Down ◽

Canal Wall Down Mastoidectomy ◽

Pediatric Cholesteatoma

Download Full-text

A technique for concurrent procedure of mastoid obliteration and meatoplasty after canal wall down mastoidectomy

Auris Nasus Larynx ◽

10.1016/j.anl.2011.11.004 ◽

2012 ◽

Vol 39 (6) ◽

pp. 557-561 ◽

Cited By ~ 9

Author(s):

Chang Woo Kim ◽

Jeong-In Oh ◽

Kyu Young Choi ◽

Sun Min Park ◽

Moon Il Park

Keyword(s):

Canal Wall ◽

Mastoid Obliteration ◽

Canal Wall Down ◽

Canal Wall Down Mastoidectomy

Download Full-text

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

The Journal of Laryngology & Otology ◽

10.1017/s0022215119002408 ◽

2019 ◽

Vol 133 (12) ◽

pp. 1074-1078 ◽

Cited By ~ 1

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.

Download Full-text

Mastoid Obliteration Using Autologous Bone Dust Following Canal Wall Down Mastoidectomy

Otology & Neurotology ◽

10.1097/mao.0000000000002839 ◽

2020 ◽

Vol Publish Ahead of Print ◽

Author(s):

Pedrom C. Sioshansi ◽

Jennifer C. Alyono ◽

Nikolas H. Blevins

Keyword(s):

Canal Wall ◽

Mastoid Obliteration ◽

Canal Wall Down ◽

Canal Wall Down Mastoidectomy ◽

Autologous Bone

Download Full-text

External Auditory Canal Reconstruction and Mastoid Obliteration Using Modified Palva Flap in Canal Wall Down Mastoidectomy With Tympanoplasty

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489419836228 ◽

2019 ◽

Vol 128 (6_suppl) ◽

pp. 69S-75S

Author(s):

Ji-Sun Kim ◽

Il Gye Lim ◽

Jeong-Hoon Oh ◽

Byung Guk Kim ◽

Ki-Hong Chang

Keyword(s):

Temporal Bone ◽

External Auditory Canal ◽

Pure Tone ◽

Pure Tone Audiometry ◽

Canal Wall ◽

Mastoid Obliteration ◽

Before And After ◽

The Status ◽

Canal Wall Down ◽

Canal Wall Down Mastoidectomy

Objective: To evaluate the effectiveness of a modified Palva flap used for external auditory canal reconstruction and mastoid obliteration in canal wall down mastoidectomy. Methods: We retrospectively analyzed patients who underwent canal wall down mastoidectomy with tympanoplasty using modified Palva flap. All patients underwent pure tone audiometry and temporal bone computed tomography (CT) before surgery, and the same tests were performed in the first year after surgery. The external auditory canal volumes were calculated by summing the areas of each section selected in temporal bone CT. For each patient, the ratio of external auditory canal volume was calculated from CT taken before and after surgery. Results: The mean of external auditory canal volume after canal wall down with a modified Palva flap was about 1.4 times larger than before surgery. The modified Palva flap is effective for the reconstruction of the external auditory canal. Both pure tone audiometry level and air-bone gap showed statistically significant improvement after surgery ( Ps = .001 and .002, respectively). Conclusions: The external auditory canal volume slightly increased, but the status of mastoid obliteration was well maintained 1 year after surgery. The modified Palva flap used in this study is an easy and effective method in external auditory canal reconstruction and mastoid obliteration.

Download Full-text