Clinical trial to evaluate the outcome of canal wall up and canal wall down tympanomastoidectomy

2020 ◽  
Vol 27 (2) ◽  
pp. 466
Author(s):  
Isil Karaer ◽  
Nuray Ensari
Keyword(s):  
Clinical Trial ◽  
Canal Wall ◽  
Canal Wall Down ◽  
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

Long-term outcome of ossiculoplasty using autogenous mastoid cortical bone

2014 ◽  
Vol 128 (10) ◽  
pp. 866-870 ◽  
Author(s):  
Z Yu ◽  
L Zhang ◽  
D Han
Keyword(s):  
Cortical Bone ◽  
Otitis Media ◽  
Chronic Otitis Media ◽  
Prosthetic Material ◽  
Canal Wall ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Canal Wall Down ◽  
Canal Wall Up

AbstractObjective:To observe the long-term outcome of ossiculoplasty using autogenous mastoid cortical bone in chronic otitis media in-patients.Methods:Sixty-one ears of 57 in-patients with chronic otitis media, with or without cholesteatoma, underwent type III tympanoplasty using autogenous mastoid cortical bone as the prosthetic material. Twenty-one ears were treated by canal wall down mastoidectomy and 40 ears by canal wall up mastoidectomy. The follow-up period was 3 to 6 years (average 4.2 years). Pure tone averages for thresholds at 0.5, 1, 2 and 3 kHz were calculated using standard conventional audiometry.Results:The pre-operative mean air–bone gap of 31.6 dB, for all ears, was reduced to 20.3 dB post-operatively. For the 40 canal wall up ears, this value decreased from 30.8 dB to 19.9 dB, and for the 21 canal wall down ears it decreased from 33.0 dB to 21.0 dB. The differences between the pre- and post-operative mean air–bone gap values were significant.Conclusion:No cases of extrusion, necrosis or resorption were exhibited for the autogenous mastoid cortical bone prosthesis. A significant hearing improvement was obtained in the majority of cases and this remained stable over time.

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

Cholesteatoma in the Pediatric Age Group

1988 ◽  
Vol 97 (1) ◽  
pp. 23-29 ◽  
Author(s):  
David R. Edelstein ◽  
Simon C. Parisier ◽  
Patricia Chute ◽  
Gurpreet S. Ahuja ◽  
Shula Wenig ◽  
...  
Keyword(s):  
Residual Disease ◽  
Senior Author ◽  
Canal Wall ◽  
Pediatric Age Group ◽  
Patient Questionnaires ◽  
Tube Function ◽  
Canal Wall Down ◽  
Extent Of Disease ◽  
Canal Wall Up

The diagnosis and management of cholesteatoma in children remains controversial. In the past 15 years, the senior author (S.C.P.) has treated 320 patients with cholesteatoma. Patients 18 years and younger composed 40% (125) of the overall group and are the basis for this report. The patient data were compiled using the history, physical examination, audiograms, radiographs, patient questionnaires, surgical findings, and postoperative observations. The surgical treatment selected was determined by the extent of disease, the configuration of the mastoid, and a clinical assessment of eustachian tube function. A middle ear tympanotomy approach was used in 17% of the patients, a canal wall up procedure in 31 %, and a canal wall down procedure in 52.3 %. The average clinical follow-up was 3.9 years, with the range being from 3 months to 13.5 years. Hearing was maintained or slightly improved in a majority of cases. Residual disease occurred in 8 % of patients, and recurrent disease in only 3 %.

scholarly journals Mastoidectomy: retrospective analysis of 137 cases in a tertiary care hospital

2017 ◽  
Vol 4 (1) ◽  
pp. 93
Author(s):  
Jaya Chrisanthus ◽  
Shibu George
Keyword(s):  
Tertiary Care ◽  
Chronic Otitis Media ◽  
Positive Association ◽  
Type I ◽  
Care Hospital ◽  
Facial Canal ◽  
Canal Wall ◽  
College Hospital ◽  
Canal Wall Down ◽  
Canal Wall Up

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Mastoidectomy is a common otologic surgery and at times can be a lifesaving procedure. The aim of the study is to analyze surgical indications, operative parameters and per-operative findings encountered. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">This is a retrospective study done in patients who had undergone mastoid surgeries between 1<sup>st</sup> Jan 2016 to 31<sup>st</sup> Dec 2016 in the Department of Otorhinolaryngology, Govt. Medical College hospital, Trivandrum.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Of the 137 patients the peak age incidence was 16 – 30 years. Cholesteatoma was present in 32% of which 91% had canal wall down mastoidectomy. 64% patients, mostly chronic otitis media- mucosal and inactive squamosal, underwent canal wall up procedure. In 62% cases the ossicular chain was eroded, which was mainly incus (87%). Abnormalities encountered within the mastoid during surgery were mainly dehiscent facial canal (17.5%), low lying dura (16.8%) and contracted antrum (15.3%). A positive association could be noted between contracted antrum and the position of sinus and dural plates, and was statistically significant. Co-existence of facial canal dehiscence with lateral canal fistula and dural plate dehiscence were also noted. The tympanoplasty procedures commonly employed in canal wall up procedures was Type I and 2, and in canal wall down procedure was Type 3. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Adequate skill development of the ear surgeons in the tertiary centre should be ensured, to individualize the procedure appropriate for each patient and optimize the outcome of surgery. Early referral to the nearby otological centre should be promoted not only to prevent complications but also for better post-surgical functional outcome.</span></p>

DYNAMIC STUDY OF HEARING IN CHILDREN AFTRE SANTIZING SERGON ON THE MIDDEL EAR

2019 ◽  
Vol 25 (3) ◽  
pp. 21-27
Author(s):  
E.A. Сhernogaeva ◽  
◽  
P.V. Pavlov ◽  
О.К. Gorkina ◽  
M.L. Zakharova ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Dynamic Assessment ◽  
Canal Wall ◽  
Suppurative Otitis Media ◽  
Saint Petersburg ◽  
Hearing Ability ◽  
Canal Wall Down ◽  
Bilateral Lesions ◽  
Medical University ◽  
Canal Wall Up

Dynamic assessment of hearing in pediatric patients having chronic suppurative otitis media with cholesteotoma was conducted. The patients included into the study were assessed after surgeries performed by canal wall up or canal wall down technique without any timpanoplasty. Functional outcomes and frequency of recurrence were estimated. We carried out a retrospective and prospective analysis of hearing ability in 35 children who had undergone surgery in ENT clinic of Saint-Petersburg State Pediatric Medical University (37 ears were operated on as two patients had bilateral lesions). Hearing ability was investigated by tone threshold audiometry. All the patients studied were followed up for not less then 1 year. Hearing ability was evaluated before the surgery,6 months and 12 months after the surgery. Hearing findings before the surgery in children operated on by canal wall up technique showed a more significant hearing loss than the ones done by the other technique. All ears demonstrated no significant hearing loss progress in both groups. However, the children after canal wall up surgery showed more frequent cholesteatoma recurrences which resulted in the need of other surgeries. Carrying out canal wall up surgery on the middle ear in children makes it possible to maintain hearing at a socially adequate level.

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