Late Changes in Ear Canal Volumes After Mastoid Obliteration

Abstract

\s=b\In this study, preoperative and postoperative ear canal volumes of ears subjected to obliterative radical mastoidectomy were assessed. The measurements were performed using sterile saline solution both at the preoperative stage (V0) and at the early (one year, V,) and the late (five to 13 years, V2) postoperative stages. The mean V0 was 0.8 mL (SD, 0.2 mL); V1, 1.0 mL (SD, 0.3 mL); and V2, 1.2 mL (SD, 0.4 mL). The differences were highly significant. Clinically, the widening of the ear canals was mainly slight and appeared evenly in the epitympanic area and in the posterior ear canal wall. (Arch Otolaryngol 1982;108:208-209) Today, techniques with intact ear canal wall or with obliteration are most often used in the surgical treatment of chronic otitis media. These techniques are the result of a long series of attempts to eliminate the disadvantages and restrictions caused by open operation cavities.1 An aspect that has often received very little attention in the evaluation of the postoperative outcome is the size of the ear canal. In the literature, there are (to our knowledge) only a few articles in which precise measure¬ ment of the ear canal size has been performed or attempted.25 Furthermore, it has been shown that the pedicle used for obliteration of the operation cavity may subse¬ quently shrink.3"·7 The purpose of the present study was to evaluate the late Accepted for publication Sept 25, 1981. From the Department of Otolaryngology, University of Oulu, Finland. Reprint requests to the Department of Otolaryngology, University of Oulu, Kajaanintie 50, 90220 Oulu 22, Finland (Dr Sorri).postoperative changes in the ear canal volumes of ears operated on using the Palva obliterative operation meth¬ od.8-9MATERIAL AND METHODS During the period from 1965 to 1971, 793 ears were operated on using the Palva operation method with obliteration by a musculoperiosteal flap.8-' The patients were checked postoperatively annually for five to 13 years at the Outpatient Clinic of the Department of Otolaryngology, Uni¬ versity of Oulu, Finland. Thorough late postoperative examinations were carried out from 1975 to 1978. The preoperative values (V0) were collected from a random sample of 98 patients. The postoperative values (V, and V2) were likewise collected from a random sample of 183 ears.All the ears underwent radical surgery because of chronic otitis media with or without cholesteatoma. The operative method8' consists of a thorough cortical mastoidectomy that uses a postauricular incision and removal of the posterior bone of the ear canal wall to the level of the lateral semicircular ear canal for eradica¬ tion of the disease. The obliteration is performed with an anteriorly based mus¬ culoperiosteal flap (Palva flap). In most cases, the operation is continued with tym¬ panoplasty as well. Of the 183 ears mea¬ sured postoperatively, the obliteration was performed using a musculoperiosteal flap only in 151 ears, while in 32 ears, inorganic bone was used as additional filling materi¬ al in the large surgical cavit...

Canal wall reconstruction and mastoid obliteration with composite multi-fractured osteoperiosteal flap

“…In a study where Palva flap was used for mastoid obliteration, the ear canal was found enlarged at both the early and the late postoperative check-up compared to the preoperative values [11]. The results of the studies, reported by Kahramanyol et al [8] in which mastoid cavities were obliterated with fascioperiosteal flap, have shown that the mastoid cavity volume was decreased by 39% due to neo-osteogenesis under fascioperiosteal flap, and that the obliteration has stayed in long term has shown radiologically [9].…”

“…These patients need life-long otologic care for the debris that accumulates due to the insufficient self-cleaning mechanism of mastoidectomy cavities. Sixteen percent of ears without cavities needs cleaning, whereas this ratio climbs to 42% for ears with cavities [11]. These patients complain of dizziness in cold weather and during swimming.…”

Shape of the Osseous External Auditory Canal and Its Relationship to Troublesome Cavities

“…However, the resulting radical cavities can be troublesome . Self‐cleansing mechanisms of the osseous external auditory canal (OEAC) are disrupted, leading to frequent consultations with otorhinolaryngologists . A multifactorial etiology has been proposed and revision surgery has proven to be very effective .…”

Frontal Sinus Obliteration by A Composite Multifractured Osteoperiosteal Flap

“…18,19 It has been reported that flaps wither away in time. 20,21 Kahramanyol and coworkers have shown that a flap properly nurtured by an artery and supported by periosteum does not wither away, but gets strong in time. 18,19 Our experience and findings, the flap fills the cavity with not only its mass but an increased bone volume in time by the neo-osteogenesis, supports the same idea.…”