Abstract
IntroductionCanal wall down tympanomastoidectomy is commonly used to treat advanced chronic otitis media or cholesteatoma. The advantages of canal wall down mastoidectomy are excellent exposure for disease eradication and postoperative control of residual disease; its disadvantages include the accumulation of debris requiring life-long otological maintenance and cleaning, continuous ear drainage, fungal cavity infections, and the occurrence of dizziness and vertigo by changing temperature or pressure.ObjectiveTo evaluate whether cavity-induced problems can be eliminated and patient comfort can be increased with mastoid cavity reconstruction.MethodsIn total, 11 patients who underwent mastoid cavity reconstruction between March 2013 and June 2013 comprised the study group, and 11 patients who had dry, epithelialized CWD cavities were recruited as the control group. The study examined three parameters: epithelial migration, air caloric testing, and the Glasgow Benefit Inventory. Epithelial migration, air caloric testing, and the Glasgow Benefit Inventory were evaluated in the study and control groups.ResultsThe epithelial migration rate was significantly faster in study group (1.63 ± 0.5 mm/week) than control group (0.94 ± 0.37 mm/week) (p = 0.003, p < 0.05). The mean slow component velocity of nystagmus of the study group (13.33 ± 5.36°/s) was significantly lower when compared to control group (32.11 ± 9.12°/s) (p = 0.018). The overall the Glasgow Benefit Inventory score was −7.21, and the general subscale, physical and social health scores were −9.71, −21.09, and +20.35, respectively in the control group. These were +33.93, +35.59, +33.31, and +29.61, respectively in the study group. All but the social health score improved significantly (0.007, 0.008, 0.018, and 0.181, respectively).ConclusionsCavity reconstruction improves epithelial migration, normalizes caloric responses and increases the quality of life. Thus, cavity rehabilitation eliminates open-cavity-induced problems by restoring the functional anatomy of the ear.
Highlights
Canal wall down tympanomastoidectomy is commonly used to treat advanced chronic otitis media or cholesteatoma
The advantages of Canal wall down (CWD) mastoidectomy include excellent exposure for disease eradication and postoperative control of residual disease[1,2]; its disadvantages include the accumulation of debris requiring life-long otological maintenance and cleaning, continuous ear drainage, cavity infections, especially with fungal pathogens, and the occurrence of dizziness and vertigo induced by changing temperature or pressure.[3]
This study examined how well cavity reconstruction surgery eliminated cavity problems and increased patient comfort by epithelial migration measurement, air caloric testing, and the Quality Of Life (QOL) assessment
Summary
Canal wall down tympanomastoidectomy is commonly used to treat advanced chronic otitis media or cholesteatoma. The overall the Glasgow Benefit Inventory score was −7.21, and the general subscale, physical and social health scores were −9.71, −21.09, and +20.35, respectively in the control group These were +33.93, +35.59, +33.31, and +29.61, respectively in the study group. The advantages of CWD mastoidectomy include excellent exposure for disease eradication and postoperative control of residual disease[1,2]; its disadvantages include the accumulation of debris requiring life-long otological maintenance and cleaning, continuous ear drainage, cavity infections, especially with fungal pathogens, and the occurrence of dizziness and vertigo induced by changing temperature or pressure.[3] This study examined how well cavity reconstruction surgery eliminated cavity problems and increased patient comfort by epithelial migration measurement, air caloric testing, and the Quality Of Life (QOL) assessment. Surgical reconstruction involves reconstructing the posterior wall of the external auditory canal with conchal cartilage, and partially obliterating the mastoid cavity with temporal muscle
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