scholarly journals Outcome of Post-Operative Mastoid Cavity Obliteration with Autologous Adipose Tissue

2020 ◽  
Vol 28 (2) ◽  
pp. 138-143
Author(s):  
Rabi Hembrom ◽  
Satadal Mondal ◽  
Indranil Sen ◽  
Amit Chakrabarti ◽  
Rupam Sinha ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Randomized Study ◽  
Chronic Otitis Media ◽  
Mastoid Cavity ◽  
Canal Wall ◽  
Group A ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy ◽  
Group B ◽  
Cavity Obliteration

Introduction Mastoid operations have been in practice for over four centuries for suppurative conditions of the ear. Intact canal wall mastoidectomy has the advantage of better functional results while canal wall down mastoidectomy offers excellent exposure for disease eradication and post operative monitoring but is associated with significant cavity problems. In order to overcome the problems associated with canal wall down procedure while retaining its advantages the concept of mastoid cavity obliteration was introduced. This study analysed the outcomes of mastoid cavity obliteration and to assess the outcomes of mastoid cavity obliteration with autologous adipose tissue. Materials and Methods A prospective, experimental, randomized study was conducted over a period of 18 months among patients presenting with active squamous variety of Chronic Otitis Media. The patients were randomly allocated to two groups, A and B. Both groups underwent canal wall down Mastoidectomy followed by obliteration with autologous adipose tissue in Group B . Results In group A, the mean duration required for complete epithelialization was 10.8 weeks. In group B, the average time taken for complete epithelialization was 5.6 weeks. All cases had their graft intact at the end of 12 weeks. Debris was present in group A for a mean duration of 9.47 weeks. In group B, debris was found for a mean duration of 3.33 weeks. Patients from group A complained of discharge from their ears for a mean duration of 7.47 weeks. In group B the same symptom persisted over 3.33 weeks. Conclusion Cavity problems encountered is considerably less in the group obliterated with adipose tissue.

scholarly journals Acetic Acid Instillation after Canal Wall Down Mastoidectomy

2015 ◽  
Vol 23 (3) ◽  
pp. 104-108
Author(s):  
Hamsa Shetty ◽  
Gangadhara K S
Keyword(s):  
Acetic Acid ◽  
Granulation Tissue ◽  
Mastoid Cavity ◽  
Canal Wall ◽  
Radical Mastoidectomy ◽  
Modified Radical Mastoidectomy ◽  
Group A ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy ◽  
Group B

Introduction: Persistent otorrhoea and granulation tissue in the mastoid cavity are common post-operative complications of Canal Wall Down Mastoidectomy. In order to avoid the same and to achieve a dry cavity instillation of acetic acid into the mastoid cavity during the post operative period is common practice. Materials and Methods In this study we assessed the results of 4% acetic acid instillation in varying quantity and frequency, in the ears after modified radical mastoidectomy. 40 Patients of chronic suppurative otitis media (atticoantral) / cholesteatoma, who underwent modified radical mastoidectomy during one and a half year period, were included in the study. The patients were divided into two groups; Group A with 30 patients and Group B with 10 patients, by simple randomization method. Group A patients were asked to instill 4% acetic acid approximately 10 to 12 drops (generously) into the mastoid cavity thrice a day for  8 weeks and were followed up every week.  10 patients  of Group B were asked to instill the same preparation only once weekly and followed up for the next 12 weeks.   Results: In Group A, dry mastoid cavity was achieved remarkably faster within six to eight weeks and in all the 30 patients. In Group B the results were delayed by up to 4 to 6 weeks in comparison to the Group A patients. Conclusion:             Though acetic acid instillation is known to help in achieving a dry cavity but a slightly higher concentration (4% acetic acid) used more frequently is highly effective in rendering dry cavity much earlier without proliferation of granulation tissue. 

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.

scholarly journals Cholesteatoma surgery by open technique with reconstruction together with same session ossiculoplasty

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Mohammed Saad Hasaballah ◽  
Peter Milad ◽  
Ossama Mustafa Mady ◽  
Ahmed Abdelmoneim Teaima
Keyword(s):  
Complete Removal ◽  
Mastoid Cavity ◽  
Canal Wall ◽  
Open Technique ◽  
Viable Option ◽  
Effective Option ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy ◽  
Cavity Obliteration ◽  
Cholesteatoma Surgery

Abstract Background This study was designed to evaluate the effect of mastoid cavity obliteration with bone chips and reconstruction of canal wall with tragal cartilage after canal wall down tympanomastoidectomy with cartilage ossiculoplasty in the same session. Sixty-three patients with cholesteatoma underwent the technique mentioned above; patients were followed for 1 year postoperative. Results No cavity problems, median preoperative air bone gap was 32.86 ± 6.24 db, while the median postoperative air bone gap was 21.67 ± 5.99 db. Conclusions Canal wall down mastoidectomy with obliteration of mastoid cavity is an effective option for the complete removal of cholesteatoma and same session cartilage ossiculoplasty is a viable option.

scholarly journals Combined conchal cartilage islet-periosteum and posterior based pedicled flap obliteration: a comparison with unobliterated mastoid cavities

2020 ◽  
Vol 6 (11) ◽  
pp. 1991
Author(s):  
Arindam Das ◽  
Sandipta Mitra ◽  
Sayan Hazra ◽  
Arunabha Sengupta
Keyword(s):  
Chronic Otitis Media ◽  
Pedicled Flap ◽  
Open Cavity ◽  
Mastoid Cavity ◽  
Volume Discharge ◽  
Cavity Volume ◽  
Canal Wall ◽  
Conchal Cartilage ◽  
Canal Wall Down ◽  
Cavity Obliteration

<p><strong>Background:</strong> Aim of the study was to compare the outcomes of a new technique of mastoid cavity obliteration with open mastoid cavity.</p><p><strong>Methods:</strong> 90 patients diagnosed with chronic otitis media (active squamosal variety) and planned to undergo surgery between 2016-2018 were randomly assigned into two groups of 45 patients. One group underwent canal wall down matoidectomy followed by cavity obliteration with posteriorly based vascularised flap with mastoid cortex periosteum plus conchal cartilage composite graft and the other underwent the same surgery but without any obliteration. The two groups were compared in terms of cavity volume, discharge, epithelisation, wax formation, subjective sensation of vertigo and post-operative air-bone gap at 1 year.</p><p><strong>Results:</strong> Cavity obliteration in post-canal wall down setting significantly reduced the post-operative cavity volume and need for cavity debridement with better epithelisation, less incidence of discharge, vertigo on caloric stimulation when compared to open cavity. The post-operative air-bone gap in obliterated cavities was better but not statistically significant.</p><p><strong>Conclusion: </strong>Cavity obliteration has definite advantages over open cavity in terms of healing but no significant differences in long-term audiological outcomes.</p>

scholarly journals Surgical and audiological outcome of canal wall down mastoidectomy in Sub Himalayan region: our experience

2017 ◽  
Vol 5 (10) ◽  
pp. 4426
Author(s):  
Kuldeep Thakur ◽  
Ajay Ahluwalia ◽  
Vikas Deep Gupta
Keyword(s):  
Hearing Threshold ◽  
Mastoid Cavity ◽  
Canal Wall ◽  
Type Iii ◽  
Type Iv ◽  
Post Surgery ◽  
Maximum Improvement ◽  
Group A ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy

Background: Pre-operative and post-operative hearing status and status of mastoid cavity were compared in patients undergoing canal wall down mastoidectomy (CWDM) with tympanoplasty.Methods: Forty-three patients who underwent surgery and completed their follow up post-surgery were included in the study. Nineteen patients underwent CWDM with type III tympanoplasty with PORP, 7 patients underwent CWDM with type III tympanoplasty without PORP and 17 patients underwent CWDM with type IV tympanoplasty with TORP.Results: Among enrolled patients, 21 patients were females and 22 patients were male. Right ear (29) was commonly involved than left ear (14). Hearing loss was predominant symptom followed by recurrent ear discharge and other symptoms. Patients underwent three types of surgeries, type III tympanoplasty with PORP (19/43), type III tympanoplasty without PORP (7/43) and type IV tympanoplasty with TORP (17/43) by using Teflon prosthesis.Conclusions: Thirty seven percent (16/43) of patients had hearing threshold <25 dB post-surgery with maximum improvement in group A 47% (9/19). Forty seven percent (20/43) patients had hearing threshold between 26-40 dB with maximum improvement in group B 43% (3/7). Twelve percent (5/43) patients had hearing threshold between 41-60dB with almost equal improvement in all three groups. Five percent (2/43) of patients had >60dB hearing threshold, all belonging to group C. Anatomical results were assessed by examining the mastoid cavity showing 95%, 72%, 70% patients in group A, B and C had well epithelialized cavity.

scholarly journals Extradimension of fasciocutaneous flap in the surgical management of postaural fistula, a complication of chronic otitis media – squamous type

2017 ◽  
Vol 3 (2) ◽  
pp. 419
Author(s):  
Madhubari Vathulya ◽  
Manu Malhotra ◽  
Saurabh Varshney
Keyword(s):  
Otitis Media ◽  
Surgical Techniques ◽  
Chronic Otitis Media ◽  
Neck Region ◽  
Fasciocutaneous Flap ◽  
Mastoid Cavity ◽  
Canal Wall ◽  
Tertiary Referral ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy

<p>Post aural fistula is one of the complications of squamous variety of chronic otitis media (COM-S). For decades together a lot of new surgical techniques have been introduced in the treatment of COM-S out of which canal wall down mastoidectomy is most commonly practised. Despite these efforts many patients presenting with COM-S end up in tertiary referral centers at a late stage with complications like fistulas and by this time a number of procedures have already been done on them. A 19 year old female presents with Postaural fistula as a complication of COM- S type. Due to the local scarring, newer flap options needed to be sought to obliterate the mastoid cavity. This article demonstrates the extra dimension for the usage of fasciocutaneous flap from neck region to treat patients of recurrent postaural fistula.</p>

scholarly journals Hearing results in modified radical mastoidectomy with type III tympanoplasty

2019 ◽  
Vol 5 (6) ◽  
pp. 1629
Author(s):  
Yash D. Lavana ◽  
Ajay J. Panchal ◽  
Vaibhav B. Hapalia ◽  
Manit M. Mandal ◽  
Shivani D. Shah
Keyword(s):  
Chronic Otitis Media ◽  
Ossicular Chain ◽  
Septal Cartilage ◽  
Mastoid Cavity ◽  
Head Group ◽  
Care Hospital ◽  
Modified Radical Mastoidectomy ◽  
Group A ◽  
The Mean ◽  
Group B

<p class="abstract" style="display: inline !important;"><strong>Background:</strong> The objective of the study was to hear the results in patients with atticoantral-chronic otitis media who undergone canal wall down mastoidectomy with different types of tympanoplasty.</p><p class="abstract"><strong>Methods:</strong> 86 cases of CSOM-AA were included. Patients were divided in 3 groups according to intra-operative ossicular chain status and reconstruction. Group A were patients having intact stapes superstructure and the graft kept over the stapes head covering middle ear and mastoid cavity. Group B patients were with intact superstructure of stapes and graft kept over cartilage graft kept on mobile stapes head. Group C patients were with absent superstructure of stapes with intact, mobile footplate and graft kept over autologous or homologous cartilage kept on footplate of stapes. On 10<sup>th</sup> week and 24<sup>th</sup> week after surgery, PTA was carried out to compare pre and post-operative hearing status. The study was conducted at SMIMER Hospital, Surat (a tertiary health care hospital) fromSeptember 2016 to September 2017.  </p><p class="abstract"><strong>Results:</strong> In 86 patients, average mean preoperative AC threshold was 48.16 (±15.15) dB, mean pre-operative BC was 8.96 (±7.85) dB and mean pre-operative air bone gap was 40.11 (±12.92) dB. The mean post-operative AC threshold was 43.17 (±13.72) dB, mean post-operative BC was 11.34 (±9.44) dB and postoperative air bone gap was 32.06 (±11.62) dB. The mean air bone gap closure was 8.76 (±11.86). This hearing gain was statistically highly significant (p&lt;0.001). Among 86 patients, cartilage was used in total 60 patients. Mean ABG was 8.6 dB, 11.05 dB and 8.43 dB respectively for tragal, conchal and homologous septal cartilage.  </p><p class="abstract"><strong>Conclusions:</strong> Hearing improvement can be achieved with appropriate reconstruction in CWD mastoidectomy.</p>

Application of amniotic membrane for covering mastoid cavity in canal wall down mastoidectomy

2019 ◽  
Vol 129 (6) ◽  
pp. 1453-1457 ◽  
Author(s):  
Mohammad Faramarzi ◽  
Reza Kaboodkhani ◽  
Sareh Roosta ◽  
Negar Azarpira ◽  
Mahmood Shishegar ◽  
...  
Keyword(s):  
Amniotic Membrane ◽  
Mastoid Cavity ◽  
Canal Wall ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy
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