Abstract
Tympanomastoid surgery for cholesteatoma is a procedure designed to eliminate the disease and maintain a safe and dry ear. This retrospective study was designed to evaluate the functional results of cholesteatoma patients who underwent canal wall down mastoidectomy in conjunction with a tympanoplasty. Operated ears due to chronic otitis media with cholesteatoma were considered for the study. The study was carried out in 120 ears. The choice of technique for tympanoplasty is based on the pathology encountered in the stapes superstructure. Patients were divided into three: 1) Group A, a type II TPL with stapes columella reconstruction; 2) Group B, a type III TPL with major columella reconstruction; and 3) Group C, a type IV TPL using a temporalis fascia and thick cartilage to shield the round window. The operated ears of Groups A and B, as compared to Group C, presented a significant decrease in the pre-operative Air-bone gap and an increase in the number of operated ears with an Air-bone gap between 0 - 20 dB. The study emphasizes the importance of functional separation of the two acoustic windows by fascia and cartilage graft when the stapes superstructure is missing but the footplate is mobile.
Highlights
IntroductionIf columella techniques are used, the columella goes from the footplate to the malleus handle or the grafted eardrum; type 4, it does not involve ossiculoplasty as such, but is protection mechanism for the round window in cases with absent ossicles, but with an intact and mobile footplate, type 4 technique includes the cavum minor technique or sound-protection techniques; type 5, this means platinectomy in cases with a fixed footplate and no ossicles
The study emphasizes the importance of functional separation of the two acoustic windows by fascia and cartilage graft when the stapes superstructure is missing but the footplate is mobile
The operated ears of Groups A and B compared to Group C presented a significant decrease in the pre-operative Air-bone gap (ABG), and an increase in the number of operated ears with an ABG between 0 - 20 dB
Summary
If columella techniques are used, the columella goes from the footplate to the malleus handle or the grafted eardrum; type 4, it does not involve ossiculoplasty as such, but is protection mechanism for the round window in cases with absent ossicles, but with an intact and mobile footplate, type 4 technique includes the cavum minor technique or sound-protection techniques; type 5, this means platinectomy in cases with a fixed footplate and no ossicles. This retrospective study was designed to evaluate the functional results of cholesteatoma patients who underwent CWD-M in conjunction with a tympanoplasty
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