Impact of Partial Mastoid Obliteration on Caloric Vestibular Function in Canal Wall Down Mastoidectomy

Abstract

Our technique of partially obliterating tympanomastoid cavities with autologous bone pâté being covered by cartilage plates results in small cavities with complete epithelialization of all surfaces. Furthermore, obliteration of mastoid cavities confers protection to the labyrinthine organ, thereby reducing postoperative vertigo on caloric stimulation.

Anatomical, functional and quality‐of‐life results for mastoid and epitympanic obliteration with bioactive glass s53p4: a prospective clinical study

“…Mastoid and epitympanic obliteration has been proposed for the rehabilitation of a canal‐wall‐down mastoidectomy to avoid cavity‐related drawbacks. Otorrhoea, difficulty in fitting a hearing aid when needed and vertigo or imbalance due to thermal stimulation of the posterior labyrinth are often undesirable outcomes of a canal‐wall‐down mastoidectomy . Obliteration has also been performed in canal‐wall‐up mastoidectomy, although less frequently, to reduce the recurrence and residual rate of cholesteatoma in adults and children and to facilitate middle ear aeration after a closed technique with insufficient postoperative middle ear aeration.…”

Mastoid cavity obliteration and vibrant soundbridge implantation for patients with mixed hearing loss

“…A broad variety of obliteration materials has been described in the literature, including but not limited to abdominal fat, muscle flaps, bony pâté, allogenous or autogenous bony chips, cartilage, hydroxyapatite, titanium, and bioactive glass …”

“…Several strategies of mastoid cavity rehabilitation have been proposed. Generally, the reduction of the cavity is desirable since it helps to overcome problems like discharge and caloric sensibility . Success rates for hearing rehabilitation by ossiculoplasty are reported to be as high as 64% in terms of air‐bone gap reduction to within 20 dB .…”

Clip Vibroplasty

“…Therefore, a moist radical cavity has to be cured with partial obliteration and enlargement of the ear canal entrance in a first-step surgery (18). The cable of the implant can be protected behind thick cartilage plates of the partial obliteration.…”