scholarly journals Modified Canal Wall Down Mastoidectomy Without Meatoplasty

2021 ◽  
Vol 64 (12) ◽  
pp. 965-970
Author(s):  
You Young An ◽  
Jong Dae Lee

It is important to decide which procedure to employ between canal wall up mastoidectomy and canal wall down mastoidectomy (CWDM) as each procedure has its own advantages and disadvantages. To combine the advantages and compensate the disadvantages of each procedure, various methods and approaches have been devised. Mastoid and epitympanic obliteration, which minimizes the dead space in the mastoid cavity, was previously known to prevent the occurrence of retraction pockets. We performed mastoid and epitympanic obliteration also to prevent the occurrence of cavity problems without meatoplasty. Here we describe the surgical procedures for modified CWDM without meatoplasty and mastoid obliteration using autologous materials.

Author(s):  
Anand Velusamy ◽  
Nazrin Hameed ◽  
Aishwarya Anand

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.


2020 ◽  
Vol 134 (6) ◽  
pp. 493-496
Author(s):  
C Carnevale ◽  
G Til-Pérez ◽  
D Arancibia-Tagle ◽  
M Tomás-Barberán ◽  
P Sarría-Echegaray

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.


2019 ◽  
Vol 133 (12) ◽  
pp. 1074-1078 ◽  
Author(s):  
M D Wilkie ◽  
D Chudek ◽  
C J Webb ◽  
A Panarese ◽  
G Banhegyi

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.


2019 ◽  
Vol 46 (4) ◽  
pp. 487-492 ◽  
Author(s):  
Matthias Balk ◽  
David Schwarz ◽  
Philipp Wolber ◽  
Andreas Anagiotos ◽  
Antoniu-Oreste Gostian

2019 ◽  
Vol 129 (6) ◽  
pp. 1453-1457 ◽  
Author(s):  
Mohammad Faramarzi ◽  
Reza Kaboodkhani ◽  
Sareh Roosta ◽  
Negar Azarpira ◽  
Mahmood Shishegar ◽  
...  

2017 ◽  
Vol 96 (10-11) ◽  
pp. 426-432
Author(s):  
Z. Jason Qian ◽  
Amy M. Coffey ◽  
Kathleen M. O'Toole ◽  
Anil K. Lalwani

Benign middle ear tumors represent a rare group of neoplasms that vary widely in their pathology, anatomy, and clinical findings. These factors have made it difficult to establish guidelines for the resection of such tumors. Here we present 7 unique cases of these rare and diverse tumors and draw from our experience to recommend optimal surgical management. Based on our experience, a postauricular incision is necessary in nearly all cases. Mastoidectomy is required for tumors that extend into the mastoid cavity. Whenever exposure or hemostasis is believed to be inadequate with simple mastoidectomy, canal-wall-down mastoidectomy should be performed. Finally, disarticulation of the ossicular chain greatly facilitates tumor excision and should be performed early in the procedure.


2010 ◽  
Vol 31 (9) ◽  
pp. 1399-1403 ◽  
Author(s):  
Dirk Beutner ◽  
Victor Helmstaedter ◽  
Robert Stumpf ◽  
Thomas Beleites ◽  
Thomas Zahnert ◽  
...  

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

2019 ◽  
Vol 12 (4) ◽  
pp. 360-366
Author(s):  
Bo Gyung Kim ◽  
Hyo Jun Kim ◽  
Seung Jae Lee ◽  
Eunsang Lee ◽  
Se A Lee ◽  
...  

2019 ◽  
pp. 014556131987978 ◽  
Author(s):  
Sherif M. Askar ◽  
Ibrahim M. Saber ◽  
Mohammad Omar

Objectives: Mastoid reconstruction principle had been described to overcome problems of chronic discharging cavity. Different materials were used; nonbiologic materials seem to be less preferred. Platelet-rich plasma (PRP) could promote the regeneration of mineralized tissues. In this work, the authors present a simple and easy technique for mastoid reconstruction with PRP and cortical bone pate. Methods: The study design is a case series. Patients had mastoid reconstruction after canal wall down mastoidectomy using PRP and cortical bone pate. Results: This study included 21 patients: 9 males, and 12 females. Sixteen patients had left side disease. All surgical procedures were conducted smoothly within 90 to 135 minutes with no stressful events had been reported. At 12 to 16 months of follow-up, external canal stenosis and mastoid fistulas were not reported. Good healing of the tympanic membrane was seen in 18 patients. No radiological signs suggestive of recurrence were detected and the reconstructed mastoid cavity was smooth and well aerated. Residual tympanic membrane perforations were detected in 3 patients. Conclusion: Autologous materials (PRP and bone pate pate) after canal wall down mastoidectomy appear to be a reliable and effective choice for mastoid reconstruction.


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