Abstract
OBJECTIVES: This study was designed to evaluate the long-term results using the technique of canal wall reconstruction (CWR) tympanomastoidectomy with mastoid obliteration in the treatment of chronic otitis media with cholesteatoma. STUDY DESIGN: Institutional review board-approved retrospective case review. SETTING: Tertiary referral center. PATIENTS: Retrospective review was performed on consecutive patients undergoing CWR tympanomastoidectomy with mastoid obliteration at a single institution from 1997 to 2011. MAIN OUTCOME MEASURES: Status of tympanic membrane and ear canal anatomy, preoperative and postoperative audiometry, residual cholesteatoma at second look surgery, postoperative complications, recurrence rate, and location. RESULTS: Two hundred eighty-five ears in 273 patients underwent CWR tympanomastoidectomy with a mean age of 35 years with average follow-up of 4.29 years (median, 3.16 yr). A second-look ossiculoplasty was performed in 253 (89%). Recurrent retraction pocket formation occurred in 34 ears (13%). A secondary endaural atticotomy only was required to improve access for debridement in 16 of these 34 ears (5.8% of total ears). Only 7 ears (2.6%) required a revision open cavity mastoidectomy (n = 5) or subtotal petrosectomy (n = 2) for recurrent cholesteatoma. Those undergoing second-look ossiculoplasty demonstrated a small improvement in preoperative versus postoperative air-bone gap (ABG), 28 dB versus 23 dB, respectively. Postoperative infection occurred in 16 patients (5.6%) with 1 patient requiring conversion to open cavity mastoidectomy. CONCLUSION: A CWR tympanomastoidectomy provides excellent intraoperative exposure of the middle ear and mastoid without the long-term disadvantages of a canal wall down mastoidectomy. Long-term follow-up demonstrates that there were only 2.6% failures requiring conversion to an open cavity or subtotal petrosectomy. LEVEL OF EVIDENCE: 4
Original language | English (US) |
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Pages (from-to) | 954-960 |
Number of pages | 7 |
Journal | Otology and Neurotology |
Volume | 35 |
Issue number | 6 |
DOIs | |
State | Published - Jan 1 2014 |
Keywords
- Cholesteatoma
- Mastoid obliteration
- Tympanomastoidectomy
ASJC Scopus subject areas
- Otorhinolaryngology
- Clinical Neurology
- Sensory Systems