Obliteration of Radical Cavities and Total Reconstruction Procedure Without Staging After Canal Wall Down Mastoidectomy: Long-term Results

Abstract

ObjectivesWe evaluate the long-term surgical and hearing results using a canal wall down mastoidectomy technique followed by cavities obliteration, canal wall reconstruction and ossiculoplasty without staging.MethodsA total of 44 patients between January 2002 and October 2009 were selected and 27 of them were revision cases. Preoperative and postoperative pure tone average (PTA) and air-bone gap (ABG) were assessed and compared 1 and 4 years after surgery.ResultsThe middle ear was well healed and aerated in 40 patients (90.9%) and the tympanic membrane was intact in 42 patients (95.5%). Recurrent cholesteatoma was found on postoperative follow-up in two of the revision patients (7.4%) but none in the primary patients. Seven patients were found to have partial canal bone absorption, but revision surgery was not required. Over 86.4% of all cases were water resistant. Long-lasting improvement and/or preservation of hearing, with maintenance of PTA-ABG closure in 63.7% of all cases within 20 dB, were obtained.ConclusionThe efficacy of our technique after a canal wall down mastoidectomy is satisfactory, and the rate of complication is acceptably low. We believe that our technique could be a convenient method in disease control and providing an excellent basis for hearing restoration simultaneously.

Keywords

• Cholesteatoma
• Mastoid
• Surgical Procedures, Operative
• Reconstructive Surgical Procedures
• Hearing