Does Mastoid Obliteration following Mastoidectomy Offer an Improvement in Quality of Life?

Abstract

Objectives: 1) Recognize the impact mastoidectomy with obliteration has on quality of life (QOL). 2) Describe the QOL change with primary or secondary mastoid obliteration with autologous bone graft. 3) Review of the literature on mastoid obliteration. Methods: This retrospective observational study was conducted to determine if mastoid obliteration with autologous cranial bone graft following mastoidectomy improves QOL. Patients with cholesteatoma who had mastoidectomy with primary or secondary mastoid obliteration by a tertiary otologist were surveyed using the validated Glasgow Benefit Inventory (GBI), our primary outcome measure. Our secondary outcomes were recurrence rates. Results: Fifty-five patients were interviewed: 44 were primary obliterations, and 11 were secondary obliterations of an existing mastoid cavity. Overall GBI scores were improved, with average scores of 25. Average general subscale scores were 26, physical health scores were 22, and social health scores were 24. The primary obliteration group had average scores of 22, general subscale scores of 23, physical health scores of 21, and social health scores of 19. Those with secondary obliteration scored higher, with average scores of 37, general subscale scores of 40, physical health scores of 21, and social health scores of 42. Recurrence rates were comparable with the current literature. Conclusions: This study shows that mastoidectomy with obliteration using autologous cranial bone graft offers a significant QOL benefit. The GBI scores compare favorably with other otology procedures. Secondary obliterations after revision mastoidectomy scored much higher than primary obliterations. This is currently the only QOL study comparing these two patient groups.