Abstract
BackgroundTo evaluate the long-term surgical outcome(s) in patients who have undergone canal-wall-down operation with mastoid and epitympanic obliteration using autologous cortical bone chips, bone pate and meatally-based musculoperiosteal flap technique.MethodRetrospective evaluation of seventy patients operated during 1986–1991 due to a cholesteatoma. An otomicroscopy was performed to evaluate the postoperative outer ear canal configuration with a modified Likert scale (1 – 4). The outer ear canal physical volume was assessed by tympanometry. The hearing outcome and a patient-filled questionnaire were also analyzed.ResultsThe posterior wall results were 1.8 (± 0.9 SD) and the attic region 1.8 (± 0.9 SD) (ns., p > 0.05). These values show either no cavity formation or minor formation of a cavity, with a good functional result. The mean volume of the operated ear canal was 1.7 (± 0.5 SD) ml. The volume of the contralateral ear canal was 1.2 (± 0.3 SD) ml (*** p < 0.0001). A comparison of the current mean ABG to the preoperative mean ABG and to the ABG at one-year postoperatively, 5-years postoperatively or 10-years postoperatively showed no statistical significance (p > 0.05).ConclusionABG does not significantly change in the long-term. The configuration of the cavity tends to change, however, the obliteration material is stable in the long-term and clinically significant cavitation rarely occurs.
Highlights
To evaluate the long-term surgical outcome(s) in patients who have undergone canal-wall-down operation with mastoid and epitympanic obliteration using autologous cortical bone chips, bone pate and meatally-based musculoperiosteal flap technique
Several authors have demonstrated the usefulness of mastoid obliteration technique and considered it a safe method to diminish a surgical cavity in CWD surgery [3,4,5,6,7]
We have studied the long term condition of ears that underwent CWD mastoidectomy with mastoid and epitympanic obliteration using autogenous bone chips, bone pate and a musculoperiosteal flap
Summary
To evaluate the long-term surgical outcome(s) in patients who have undergone canal-wall-down operation with mastoid and epitympanic obliteration using autologous cortical bone chips, bone pate and meatally-based musculoperiosteal flap technique. Canal-wall-down (CWD) tympanomastoidectomy is a well established method in surgery due to cholesteatoma [1]. It provides a good intraoperative exposure and an easy postoperative monitoring. CWD surgery creates a large open cavity, with several possible problems [11]. Both autologous and synthetic materials have been used for obliteration [3,12,13,14]. The CWD tympanomastoidectomy with this obliteration method has been well characterized [15,16]
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