Mastoid Cavity Obliteration Research Articles

Therapeutic effect of β-tricalcium phosphate in mastoid cavity obliterationunder endoscope

Objective:To investigate the therapeutic effect of β-tricalcium phosphate in mastoid cavity obliteration for middle ear cholesteatoma under endoscope. Methods:Sixty patients with middle ear cholesteatoma admitted to our department from September 2021 to March 2022 were included in this study. The observation group（n=30） received β-tricalcium phosphate during mastoid cavity obliteration. The control group（n=30） received autologous tissue during mastoid cavity obliteration. Pure tone audiometry was performed before surgery and after surgery in both groups, and the air conduction thresholds of 500, 1 000, 2 000 and 4 000 Hz were recorded. The external acoustic meatus cross-sectional area within 1 cm of the external acoustic meatus opening was measured during the operation and after the operation. The differences of postoperative ear drying time, hearing change and mastoid cavity healing were compared between the two groups. Results:The duration of postoperative dry ear in the observation group was 2-14 weeks, with an average of （9.4±2.7） weeks, while that in the control group was 4-26 weeks, with an average of（16.0±5.7） weeks. The difference in dry ear time between the two groups was statistically significant（P<0.05）. In the observation group, the threshold change was -19-27 dB, with an average of（6.4±10.7） dB, and in the control group, the threshold change was -9-17 dB, with an average of （4.7±7.1） dB. There was no significant difference in hearing change between the two groups（P>0.05）. In the observation group, the cross-sectional area of 1 cm inside the ear canal opening was -5.9-8.2 mm², with an average of （-0.6±2.6） mm², and in the control group, the cross-sectional area of 1 cm inside the ear canal opening was -5.5-5.2 mm², with an average of （-0.4±2.3） mm². There was no significant difference in intraoperative cavity changes between the two groups（P>0.05）. Conclusion:The application of β-tricalcium phosphate to fill the mastoid cavity during the operation of endoscopic middle ear cholesteatoma has no adverse effect on the hearing of patients, can shorten the postoperative dry ear time, and results in good postoperative healing, which is worth promoting.

Renewed Concept of Mastoid Cavity Obliteration with the Use of Temporoparietal Fascial Flap Injected by Injectable Platelet-Rich Fibrin after Subtotal Petrosectomy for Cochlear Implant Patients.

Background: The subtotal petrosectomy procedure may be useful for cochlear implantation in selected patient groups. Although it is highly effective, complications can arise, which may have economic implications for the patient due to the high cost of the device. Therefore, several authors have attempted to identify the most effective concept for obliteration. Methods: We present a pilot descriptive study of application techniques for obliterating cavities after subtotal petrosectomy using a temporoparietal fascial flap (TPFF) modified with injectable platelet-rich fibrin (IPRF+) for three cochlear implant (CI) patients. Results: Our concept preserves important anatomical structures, such as the temporalis muscle, which covers the CI receiver-stimulator. Injection of IPRF+ also increases the available tissue volume for obliteration and enhances its anti-inflammatory and regenerative potential. Conclusions: To the best of our knowledge, the use of TPFF for filling the cavity has not been adopted for CI with SP and for blind sac closure. Our literature review and our experience with this small group of patients suggest that this procedure, when combined with IPRF+ injections, may reduce the risk of potential infection in the obliterated cavity, particularly when used with CI. This technique is applicable only in cases when the surgeons are convinced that the middle ear cavity is purged of cholesteatoma.

Comparative Analysis of Various Materials Used for Mastoid Cavity Obliteration in Canal Wall Down Mastoid Surgery.

To study the surgical result and efficacy of different methods of mastoid obliteration with cavity care. This prospective study included 60 patients who had cholesteatoma, conducted in the Department of Ear Nose and Throat (ENT), Institute of Medical Sciences, Banaras Hindu University, Varanasi from July 2015 to July 2017. The mastoid cavity was obliterated with either muscle flap/bone dust/hydroxyapatite. detailed history otoscopic examination was done pre-operatively and follow up were recorded at 1month and 3months in postoperative period. 60 patients were included, who underwent canal wall down mastoid surgery. each group muscle flap (group 1), bone dust (group 2) and hydroxyapatite (group 3) included 20 patients, age group 31-40year with its maximum incidence of 43.3%, Preop PTA value were almost equal in all group but on comparison at 1month in postoperative period significant improvement was present in group 1 versus 2(0.021) and group 2 versus 3(0.003) but not in group 1 versus 3. Although at 3month there were significant improvement was present in all groups. The incidence of pain, discharge, giddiness and wax formation were markedly reduced and healing of cavities was early and better in obliterated cavities done by muscle flap and bone dust material as compared to hydroxyapatite cavities, at the end of 3months. outcome and quality of life was better and almost equal in muscle flap and bone dust material group as compared to hydroxyapatite group.

Comparative study of quality of life and surgical outcome in open mastoid cavity and mastoid cavity obliteration in canal wall down mastoidectomy

Background: Canal wall down mastoidectomy is a surgical technique used for the eradication of middle ear disease. The remaining large mastoid bowl is associated with a number of issues; one of the techniques that have been developed in order to avoid such problems is the obliteration of the mastoid cavity. Mastoid obliteration resulted in a decrease in the complications associated with the open mastoid cavity. The materials used for this reason are either biological or synthetic. Mastoid obliteration with synthetic materials is a valuable and safe surgical technique for patients who undergo canal wall down mastoidectomy. Methods: This is a prospective study carried out in the department of otorhinolaryngology. Sample size: 30 patients out of which 15 were operated by Modified Radical Mastoidectomy with obliteration (Group A) and 15 were operated by Modified Radical Mastoidectomy without obliteration (Group B). Study design: single centre, longitudinal, prospective, two group, parallel, follow-up, randomly allocated statistical method and tools: Fischer’s Exact Test. Study period: August 2017 to August 2020. Results: Study was divided in two groups, group A (modified radical mastoidectomy with obliteration) &amp; group B (modified radical mastoidectomy without obliteration). Conclusions: The incidence of pain, discharge, giddiness and wax formation was markedly reduced in obliterated cavities as compared to open cavities. Healing of the cavity as evidenced by epithelialization, at the end of 3 months, was better in obliterated ears. Patients with obliterated mastoid cavity required less cavity care, doctor dependence, frequent OPD visits.

Two Cases of Abnormal Auditory Sensation After Exposure of the Posterior Fossa Dura Membrane to the Mastoid Cavity Treated by Mastoid Cavity Obliteration

Two Cases of Abnormal Auditory Sensation After Exposure of the Posterior Fossa Dura Membrane to the Mastoid Cavity Treated by Mastoid Cavity Obliteration

Modified Radical Mastoidectomy: Open Mastoid Cavity versus Cavity Obliteration Using Periosteal Temporofascial Flap - A Comparative Study

Introduction The surgical treatment of Chronic Otitis Media by modified radical mastoidectomy usually results in an open cavity, with chronic discharge, hearing loss of 30 to 40 dB, frequent visits to OPD for debris removal and none the less dizziness on cold air exposure. One way to deal with these issues effectively is to obliterate the mastoid cavity. In our study we used vascularised periosteo-temporofascial swing flap with medicated bone dust to obliterate the mastoid cavity. Material and Methods In this prospective study, 50 patients who suffered from chronic otitis media, active squamous (cholesteatoma) disease, and underwent modified radical mastoidectomy with tympanoplasty procedure were and split between two equally sized groups. Group 1 had patients with open mastoid cavity and Group 2 had obliteration of mastoid cavity using vascularised periosteo-temporofascial swing flap with medicated bone dust. Patients were followed at 3rd week, 6th week, 3rd month and 6th month. Results Patients with cavity obliteration had better and statistically significant outcomes in term of discharge status of cavity and epithelization at 3 weeks. Patients with obliteration also had positive and statistically significant results in hearing levels and hearing gain at 6 months follow up. Conclusion Mastoid cavity obliteration with vascularised periosteo-temporofascial swing flap with medicated bone dust is a good and effective method for better post-operative outcomes and curtailing dependency on doctors for cavity care.

Inter and Intraobserver Agreement of the IOOG SAMEO ATO Classification for Tympanomastoid Surgery.

In 2018 the International Otology Outcome Group (IOOG) introduced the stage of surgery, approach, mastoidectomy, external ear canal reconstruction, obliteration of mastoid cavity, access to middle ear, tympanic membrane, ossicular chain (SAMEO ATO) categorization framework for tympanomastoid surgery to develop a classification system that encompasses all aspects of surgical technique that are likely to influence the outcome of tympanomastoid surgery. To date there is no study that examines inter or intraobserver reliability of this classification system. To assess inter and intraobserver reliability of the SAMEO ATO classification. Retrospective single center study. Two observers independently categorized 167 tympanomastoid surgeries using the SAMEO-ATO system to allow for interobserver analysis. Categorization was performed retrospectively from operation notes. Intraobserver reliability was evaluated for one observer. One hundred sixty seven tympanomastoid surgeries performed by a single surgeon between 2018 and 2021. Inter and intraobserver reliability calculated using Cohen's kappa. Almost perfect interobserver agreement was seen for stage of surgery ( S ), approach ( A ), mastoidectomy ( M ), and ossicular chain ( O ) with kappa scores ranging from of 0.957 to 0.848.Almost perfect intraobserver agreement was seen for approach ( A ), mastoidectomy ( M ), external ear reconstruction ( E ), obliteration of mastoid cavity ( O ), access to middle ear ( A ), and ossicular chain ( O ) with kappa ranging from 0.929 to 08.21. The SAMEO ATO classification is a reliable system for recording surgical procedures. Given the complexity of the SAMEO ATO classification it is vital that those using it have a thorough knowledge of the classification.

An Effective Method to Collect Bone Dust for Mastoid Cavity Obliteration.

To compare the volume of cortical bone dust collected and the time taken for bone dust collection by using a self-devised bone dust collector and that by manual method using a metal scoop in patients undergoing modified radical mastoidectomy with mastoid cavity obliteration. A prospective study was done in 62 patients of cholesteatoma. They underwent canal wall down mastoidectomy. Mastoid cavity was obliteration was done using cortical bone dust collected after dividing the patients randomly into 2 groups: (1) usinga collector device made using a mucous extractor fitted with a nylon mesh of size 1″ × 3″attached to the suction tube, (2) collected manually by using a metal scoop. The time taken for the collection of bone dust was recorded and the volume of bone dust collected was measured and recorded. We found that the time taken for the collection of bone dust was significantly lower and the volume of bone dust collected was higher using a mucous extractor as compared to that by manual collection using a metal scoop. The suction based mucous extractor performed better in terms of both time taken for collection and also in the volume of cortical bone dust that was collected as compared to manual collection using a metal scoop. Therefore, we conclude from our study that using the suction based mucous extractor is a more effective method of cortical bone dust collection for mastoid cavity obliteration.

Comparison of Outcomes of Open Mastoid Cavity- with or Without Obliteration.

For a chronically discharging ear open mastoidectomy is the mainstay of treatment, however it can cause high morbidity due a large cavity and complications like discharge, vertigo and difficulty with hearing aids. To avoid such problem, obliteration of mastoid cavity is done. The objective of our study was to compare the post-operative complains, the hearing results and outcomes of open and closed mastoid cavity. The present prospective study was conducted on 40 patients having attico-antral disease in middle ear cleft. Patients were randomly divided into two groups of 20 each. Out of 40 patients, in 20 patients (Group A) mastoid obliteration was done using conchal cartilage, whereas in other 20 patients (Group B) canal wall down mastoidectomy without mastoid obliteration was done i.e.an open cavity. The patients were followed up post-operatively at 6th week, 3rd month and 6th month. Study Design: comparative study. On Pure Tone Audiometry, 13 (65%) patients with closed mastoid cavity had Air-bone Gap < 30dB, 7 (35%) were in the range 30-60dB as compared to open mastoid cavity where 10 (20%), 8 (40%), 2(10%) patients had ABG < 30db, 30-60dB, and > 60dB respectively, showing better hearing results in obliterated cavities, healing was also better. In obliterated mastoid cavities, there were very few complications of pain, discharge, and giddiness compared to open cavities. Healing as shown by epithelisation was earlier and better in obliterated cavities. Hearing results were better in mastoid cavities with obliteration compared to open cavities. Patients with obliterated mastoid cavity need less cavity care and doctor dependence.

Mastoid obliteration during last 5 years

The article presents modern approaches to mastoid obliteration in cases of chronic purulent otitis media with cholesteatoma, published in peer-reviewed russian and foreign journals from 2017 to 2021. The review tells us about effect of mastoid cavity obliteration on reducing the recurrence of cholesteatoma, improving the quality of life of patients according to the results of international questionnaires and the effect of surgery on hearing in the long-term postoperative period. An analysis of the use of autologous and biocompatible materials in middle ear surgery is presented. Their safety and ease of use during surgical intervention were evaluated.

Mastoid cavity obliteration with bone dust: a retrospective study of 34 cases

&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Chronic suppurative otitis media leads to ear discharge with hearing loss with squamosal type often presents with cholesteatoma and mainstay of treatment is surgical. Modified radical mastoidectomy is the ideal surgical option in these cases but it results in open mastoid cavity formation with certain common cavity problems. This study done to find the results of mastoid cavity obliteration with autologous bone dust and how this technique is effective in avoiding long term cavity problems and assists in ossiculoplasty.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This is a retrospective observational study done in a tertiary care hospital. Patients presented with squamosal type of chronic otitis media were operated for a canal wall down modified radical mastoidectomy.The mastoid cavity was obliterated using bone dust. A follow up of the patients was done and the healing of the cavity with the hearing result assessed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study includes total of 34 patients. 58.82% were male and 41.18% were female. All patients underwent canal wall down modified radical mastoidectomy and obliteration of the mastoid cavity was done with bone dust. The common cavity problems of discharge, debris were markedly reduced in an obliterated cavity with better healing of the cavity. The middle ear aeration was maintained assisting the ossicular reconstruction.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study showed that mastoid cavity obliteration with bone dust offers significant long term benefits in providing dry, well epithelized cavity at the same time assisting in ossicular reconstruction.&lt;/p&gt;

Bioactive glass in canal wall reconstruction tympanoplasty

The purpose of this Technical Note is to describe the surgical technique to transform canal wall down tympanoplasty into canal wall up tympanoplasty, that is, to rehabilitate a recess cavity by filling the mastoid and epitympanic cavities with synthetic tissue (bioactive glass) and recreating a normal-caliber external auditory canal. Mastoid cavity obliteration leads to a clinically significant improvement in health-related quality of life without increasing risk of recurrent or residual cholesteatoma, conditional upon technically impeccable surgery.

Mastoid Obliteration Using Bioactive Glass—Our Experience

Abstract Aims The aim of this study was to evaluate the surgical outcome of cavity obliteration with bioactive glass in patients with cholesteatoma undergoing canal wall down mastoidectomy with reconstruction of the canal wall. Materials and Methods A prospective study was conducted over a period of 3 years on 25 patients who underwent mastoid obliteration with bioactive glass following canal wall down mastoidectomy for cholesteatoma. The primary outcome measure was the presence of a dry, low-maintenance mastoid cavity that was free of infection, assessed, and graded according to the grading system by Merchant et al at the end of 1 and 6 months postoperatively. Secondary outcome measures included presence of postoperative complications like wound infection, posterior canal wall bulge, and residual perforation. Results Out of the 25 patients on whom this study was conducted, at the end of 1 month 60% had a completely dry ear, 28% of patients had grade 1, and 12% had grade 2 otorrhea at the end of the first month. At the end of 6 months, 72% had a completely dry ear, while 20% had grade 1 and 8% had grade 2 otorrhea. There were no cases with grade 3 otorrhea during the entire follow-up period. Postoperative complications of the posterior canal bulge were noted in two patients (8%), and one patient (4%) had a residual perforation. Conclusion Mastoid cavity obliteration with bioactive glass is an effective technique to avoid cavity problems.

A Multicenter Retrospective Case Review of Outcomes and Complications of S53P4 Bioactive Glass.

Objective:The objective of this multicenter retrospective case review was to assess the natural clinical course, efficacy, and safety of mastoid obliteration with S53P4 Bioactive Glass (bioactive glass).Methods:Retrospective case note review in a regional Tertiary Referral Centre and District General Hospital. Patients undergoing mastoid cavity obliteration as part of primary or secondary procedure with bioactive glass between 2012 and 2018. Outcome measures were assessed from a prospectively collated database and case note review. Primary outcomes were the common morbidities of a mastoid cavity; dry or discharging ear (Merchant’s scale), vertigo in cold air, and a watertight middle ear. Patients were also assessed for audiological outcomes and recidivism.Results:Ninety patients were included. During the follow-up period, (mean, 22 months; range, 6-59 months) cholesteatoma recidivism was observed in 2% of ears (2 patients). An acceptably dry (Merchant Grade 0-1) ear was achieved in 91% of all ears (95% primary cases, 80% secondary cases). Delayed healing of the graft in the external ear canal retaining the S53P4BAG Bioactive Glass (BonAlive Ò (BonAlive Ò Biomaterials Ltd., Turku, Finland)) within the mastoid occurred in 13% (12 ears). However, in all cases, conservative management resulted in complete healing.Conclusions:Bioactive glass provides a safe and effective means of mastoid obliteration. Complications including overlay graft failure and slow epithelialization, resulting in prolonged postoperative discharge (up to 2 months) and dehiscence into the external ear canal, do not preclude full recovery and may be successfully managed conservatively.

Mastoid cavity obliteration using bone pâté versus bioactive glass granules in the management of chronic otitis media (squamous disease): a prospective comparative study

To compare the efficacy of bone pâté versus bioactive glass in mastoid obliteration. This randomised parallel groups study was conducted at a tertiary care centre between September 2017 and August 2019. Sixty-eight patients, 33 males and 35 females, aged 12-56 years, randomly underwent single-stage canal wall down mastoidectomy with mastoid obliteration using either bone pâté (n = 35) or bioactive glass (n = 33), and were evaluated 12 months after the operation. A dry epithelised cavity (Merchant's grade 0 or 1) was achieved in 65 patients (95.59 per cent). Three patients (4.41 per cent) showed recidivism. The mean air-bone gap decreased to 16.80 ± 4.23 dB from 35.10 ± 5.21 dB pre-operatively. The mean Glasgow Benefit Inventory score was 30.02 ± 8.23. There was no significant difference between the two groups in these outcomes. However, the duration of surgery was shorter in the bioactive glass group (156.87 ± 7.83 vs 162.28 ± 8.74 minutes; p = 0.01). The efficacy of both materials was comparable.

Mastoid cavity obliteration with allogenic and autologous material

Surgical obliteration is the treatment of choice for symptomatic mastoid cavities. Various methods and materials are available. Allogeneic material is easily available but can lead to wound infections due to rejection, granulation and inflammatory reactions. Consequently, autologous material is often preferred due to its good biocompatibility. The aim of this study was to compare the long-term outcomes of patients after mastoid cavity obliteration with allogeneic and autologous material with regard to the occurrence of recurrent cholesteatoma, the number of revision surgeries and the impact of surgery on the health-related quality of life. Patients who underwent mastoid cavity obliteration with an allogeneic material (hydroxyapatite matrix [HMM]) were retrospectively included in the study. In a prospective part, patients who underwent mastoid cavity obliteration with autologous reconstruction material (AutoM) were included. In addition to a detailed chart review, all patients underwent pure tone audiometry and completed the Zurich Chronic Middle Ear Inventory (ZCMEI-21) at the postoperative examination to assess health-related disease-specific quality of life. A total of 22 patients with a mean age of 56.9 (SD 18.7 years) receiving HMM (mean follow-up interval: 88.3 months [SD 21.9 months]) and 25 patients with a mean age of 52.4 years (SD 13.7 years) receiving AutoM (mean follow-up interval: 13.5 months [SD 9.5 months]) were included in the study. The revision-free rate for audiological indication after one year was 100% for HMM and 85% for AutoM. The recurrence-free rate at one year was 95% for HMM and 100% for AutoM. 55% of the patients with alloplastic material and 8% of the patients with autologous material required revision surgery due to ear discharge or recurrent cholesteatoma. The groups did not differ in terms of postoperative hearing outcome or postoperative quality of life. Obliteration of mastoid cavities is a surgical challenge. There was no relevant difference between the materials used in terms of recurrence rate, hearing and health-related quality of life within the 13.5-month observation period of both groups. The lack of subjective symptoms together with the high rate of recurrent cholesteatoma and revision indications emphasises the need for regular clinical follow-up including ear microscopy in chronic middle ear disease and strongly suggests regular follow-up examinations.

Secondary Obliteration Surgery for Troublesome Mastoid Cavities: A Prospective Series of 228 Pediatric and Adult Cases.

To present the results of a 15-year longitudinal study in a pediatric and adult population with secondary obliteration of troublesome mastoid cavities. Prospective longitudinal study. Children (≤16 yrs) and adults who had obliteration surgery (228 ears) between 2000 and 2017. Therapeutic. Tertiary referral center. 1) Incidence of recurrent or residual cholesteatoma; 2) creation of a dry ear at 5 years postsurgery; 3) postoperative complications; 4) waterproof status of ear; 5) number of subsequent ear surgery required. Thirty-one pediatric and 197 adult cases contributed to the study. At 5 years 11 of 98 (10.8%) had been lost to follow-up. Using Kaplan-Meier survival analysis, the residual rate after 5 years was 4.2% (95% CI: 0.3%-8.2%) and the recurrence rate was 1% (95% CI: 0.0%-3.0%). Of the 223 ears available for assessment, 209 (93.7%) achieved a dry state, 6 (2.7%) had intermittent discharge, 6 (2.7%) had flap necrosis requiring flap trimming, and 1 (0.4%) developed meatal stenosis. Using a cross-sectional analysis at 12 months of follow-up, the otorrhea risk was 19.2% and the risk of definitive waterproofing was 10.9%. There was a reoperation risk of 10% within 5 years which included second-stage ossiculoplasty. Secondary mastoid obliteration is a safe and useful technique in treating the troublesome mastoid cavity in both children and adults. It is associated with a low cholesteatoma recidivism rate and high rate of a trouble-free ear in the long term.

Cholesteatoma surgery by open technique with reconstruction together with same session ossiculoplasty

BackgroundThis study was designed to evaluate the effect of mastoid cavity obliteration with bone chips and reconstruction of canal wall with tragal cartilage after canal wall down tympanomastoidectomy with cartilage ossiculoplasty in the same session. Sixty-three patients with cholesteatoma underwent the technique mentioned above; patients were followed for 1 year postoperative.ResultsNo cavity problems, median preoperative air bone gap was 32.86 ± 6.24 db, while the median postoperative air bone gap was 21.67 ± 5.99 db.ConclusionsCanal wall down mastoidectomy with obliteration of mastoid cavity is an effective option for the complete removal of cholesteatoma and same session cartilage ossiculoplasty is a viable option.

Mastoid Cavity Obliteration with Hydroxyapatite Granules

Background: Modified radical mastoidectomy is the mainstay in the treatment of a case of unsafe CSOM. In order to reduce the side effects of an open matoid cavity, many methods to obliterate the cavity have been devised. Aims &amp; Objectives: Cavity obliteration was done to study the efficacy of mastoid cavity obliteration Material and Methods: We carried out cavity obliteration with hydroxyapatite in 20 patients and compared the results with non obliteration. Results: We observed that in addition to reduction in size of cavity, there is better epithelisation and hence faster healing of the mastoid cavity. There is also a significant improvement in hearing status of the patients. Conclusion: Modified Radical Mastoidectomy followed by cavity obliteration with hydroxyapatite granules has numerous advantages compared to leaving the cavity as such.

Mastoid cavity obliteration in treatment of middle ear cholesteatoma

Objective: The primary goal in the surgical management of chronic otitis media with cholesteatoma is the creation of a dry and safe ear. The method of choice for management of cholesteatoma is the inside out or reverse mastoidectomy. If external auditory canal reconstruction after complete cholesteatoma removal is not possible, mastoid cavity obliteration techniques are recommended to reduce the size of the open mastoid cavity. The goal of our study is to evaluate the frequency of postoperative ear secretion and hearing situation in patients with mastoid cavity obliteration in treatment of middle ear cholesteatoma. Methods: Retrospective study of 155 patients with middle ear cholesteatoma were surgically treatment during 52 months from 01.06.2014 to 30.09.2018 in Hospital Trakia Park, Stara Zagora (Bulgaria) with canal wall reconstruction or mastoid cavity obliteration with cartilage, bone pate or bone replacement alloplastic materials. Results: After complete cholesteatoma removal we perform ear canal reconstruction in 51.61% of cases (80; n=155), and in others 41.94% of cases (65; n=155) we perform mastoid cavity obliteration. In our patient group we perform type I tympanoplasty in 36.77% (57; n=155), type III tympanoplasty in 46.45% (72; n=155), Secondlook operations in 14% (21, n = 155) and only in 5 cases we left the operating cavity open (3.23%; n=155). After mean follow-up period from 11.34 months (1÷48 months; SD 13.10 months) our frequency of postoperative ear secretion is 6.45% (10; n=155) and our cholesteatoma residual rate is 9.03% (14; n=155). Conclusion: Mastoid cavity obliteration procedures can prevent the development of postoperative retraction pockets by isolation the tympanic cavity from the attic and mastoid. This is a safe and effective technique for rehabilitation of mastoid cavities. Hearing results of this technique is variable according to the involvement of the middle ear ossicles, but with the possibility of fitting a hearing aids or middle ear implants.