Tympanomastoid obliteration for recalcitrant attico-antral chronic suppurative otitis media

Abstract

Though the standard canal wall up and canal wall down mastoidectomies provide for reliable disease removal and good functional outcome in most cases with atticoantral chronic suppurative otitis media (CSOM), few cases remain unresponsive to such treatment. This report describes the application of tympanomastoid obliteration with blind sac closure of the EAC as a surgical technique for recurrent CSOM persisting despite multiple previous surgical treatments. Though maximal conductive deafness is an inevitable consequence of this procedure, such morbidity may even otherwise be inevitable in this clinical situation, as scarring and destruction consequent to disease and previous surgical treatments often lead to clinical situations not amenable to tympanoplasty and hearing reconstruction. Further concerns of recurrent epithelial pearls and implantation cholesteatoma can be currently addressed by follow-up MR scanning.