Mastoid cavity obliteration: Our experience

This study was aimed to evaluate surgical outcome of patients undergoing obliteration of mastoid cavity with postauricular composite osteo-periosteal flap. This interventional study was carried out on 100 patients having unsafe CSOM from Nov. 2012 to Oct. 2014 who underwent canal wall down mastoidectomy with tympanoplasty and obliteration of cavity using composite osteo-periosteal flap. The primary outcome measure was control of suppuration and creation of dry, low-maintenance mastoid cavity, which was assessed using Merchant et al. grading system. At the end of 1 year follow-up, 89% patients had Grade 0 summary score while Grade 3 which was considered as failure of control of infection was not obtained in any patient during the entire follow-up period. Mastoid cavity obliteration using composite osteo-periosteal flap is an effective technique to avoid cavity problems.

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“…60 cases (60%) were in the age group 11-30 years. This finding was comparable with the study by Deshmukh et al [10].…”

Section: Age and Gender Distributionsupporting

confidence: 93%

“…These findings were comparable with the following studies. In a study by Deshmukh et al [10], all the patients (100%) presented with complaint of ear discharge, 86.6% presented with history of decreased hearing and only 13% presented with tinnitus. Vertigo was seen in only 6% of the patients.…”

Section: Symptomsmentioning

confidence: 96%

Surgical Outcome of Mastoid Cavity Obliteration Using Postauricular Composite Bone with Periosteum Flap

Shah

Patel

Pawde

2017

Indian J Otolaryngol Head Neck Surg

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“…ile Wadhwa ve ark., benzer çalışmalar yapmış ve bu çalışmalarda, obliterasyon grubundaki hastaların iyileşme sonuçlarının obliterasyon yapılmayanlara göre çok daha iyi olduğu bulunmuş olsa da çalışmamızda anlamlı fark bulunmamıştır. 14,15 Açık kavite mastoidektomilerde DKY'nin rezonans özelliklerinde değişiklik olması ve hastalığın eradikasyonunun sağlanabilmesi için kemikçiklerin bir kısmının çıkarılması nedeni ile işitmenin bozulması söz konusudur. 16 Evans ve ark., açık mastoid kavitelerde DKY rezonans frekansında önemli ölçüde azalma saptamışlardır.…”

Section: Preoperati̇f Muayene Ve İşi̇tme Bulgulariunclassified

Comparison of the Recovery Results of Patients Who Underwent Canal Wall-Down Mastoidectomy with or Without Obliteration

Temiz¹,

Ketenci²,

Vural³

et al. 2019

KBB ve BBC Dergisi

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Ö ÖZ ZE ET T A Am ma aç ç: : Açık teknik mastoidektomi yapılan hastalarda, kavite obliterasyonu yapılanlarla yapılmayanların iyileşme sonuçlarının karşılaştırılmasıdır. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Kolesteatomlu kronik otitis media nedeni ile açık kavite mastoidektomi yapılan hastalar iki gruba ayrıldı. Birinci gruba kıkırdak ve temporal fasiya ile kavite obliterasyonu yapılır iken, ikinci gruba obliterasyon yapılmadı. Çalışmaya 65 hasta alındı. Ancak takibe gelmeyenler nedeniyle çalışma 54 hasta ile tamamlandı. Obliterasyon yapılan grupta 24, diğer grupta 30 hasta bulunmakta idi. Ameliyat öncesi işitme eşikleri kaydedilen hastaların ameliyat sonrası testleri bir ve altıncı ayda yapıldı. Muayene bulguları kaydedildi. Kavite hacimleri ölçüldü ve karşılaştırıldı. İstatistiki anlamlılık için p<0,05 kabul edildi. B Bu ul lg gu ul la ar r: : Birinci grupta ortalama saf ses işitme eşiği ve hava-kemik açıklığı (HKA) değeri postoperatif altıncı ayda sırasıyla 51,8 ve 26,1 dB bulunur iken, ikinci grupta 50,4 ve 24,6 dB bulundu. Birinci grupta ortalama 5,2, ikinci grupta beş haftada kuru kulak elde edilirken; birinci grupta 6,45, ikinci grupta ise 6,33 haftada epitelizasyon tamamlandı. Birinci grupta birinci ayda kavite hacmi 1,91 ve altıncı ayda 1,65 mL bulunur iken, ikinci grupta 1,93 ve 1,66 ml bulundu. S So on nu uç ç: : İki grup arasında postoperatif işitme eşikleri, kuru kulak elde etme ve epitelizasyonun tamamlanma süreleri, kavite hacimleri açısından istatistiki olarak anlamlı fark bulunmamıştır.A An na ah ht ta ar r K Ke el li im me el le er r: : Kolesteatom; mastoidektomi; obliterasyon A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : To compare the results of canal wall-down mastoidectomy with or without obliteration. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : Patients who underwent canal wall-down mastoidectomy were divided into two groups. Obliteration with cartilage graft and temporal fasica was made in the first group and not made in the second. The study started with 65 patients but was terminated with 54 patients because of patients' non-attendance. There were 24 and 30 patients in obliteration and non-obliteration groups respectively. Preoperative hearing thresholds were recorded and postoperative tests were made 1 and 6 months after the operation. Also examination findings and cavity volumes were recorded and compared. p value <0.05 was considered statistically significant. R Re e-s su ul lt ts s: : The average value of pure tone hearing thresholds and air-bone gaps in the 6 th month were 51.8 and 26.1 dB in the first group and 50.4 and 24.6 dB in the second. Time of getting dry ear was 5.2 weeks in the first group and 5 weeks in the second. Completion time of epitelization was 6.45 weeks in the first group and 6.33 weeks in the second. Value of cavity volume was 1.91 and 1.65 mL in the first and sixth month in the first group and 1.93 and 1.66 mL in the second. No significant scanning difference was found. C Co on nc cl lu us si io on n: : No significant d...

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“…187 Mastoid obliteration with 1-stage eradication of the disease and a total reconstruction procedure provide long-term hearing improvement with a low incidence of persistent or recurrent disease in adults and children. [195][196][197][198][199][200][201][202][203] A quality-oflife study 204 conducted on patients with cholesteatoma who underwent mastoidectomy and mastoid obliteration with autologous cranial bone graft indicated a significant quality-oflife benefit from the procedure. Csakanyi et al 205 constructed a mathematical model that predicted that mastoid obliteration can improve ME gas pressure balance, resulting in better long-term outcome in MEs with poor mastoid pneumatization and ETD.…”

Section: Physiology and Pathophysiologymentioning

confidence: 99%

Panel 2: Anatomy (Eustachian Tube, Middle Ear, and Mastoid—Anatomy, Physiology, Pathophysiology, and Pathogenesis)

Alper

Luntz

Takahashi

et al. 2017

Otolaryngol.--head neck surg.

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Objective. In this report, we review the recent literature (ie, past 4 years) to identify advances in our understanding of the middle ear-mastoid-eustachian tube system. We use this review to determine whether the short-term goals elaborated in the last report were achieved, and we propose updated goals to guide future otitis media research.Data Sources. PubMed, Web of Science, Medline.Review Methods. The panel topic was subdivided, and each contributor performed a literature search within the given time frame. The keywords searched included middle ear, eustachian tube, and mastoid for their intersection with anatomy, physiology, pathophysiology, and pathology. Preliminary reports from each panel member were consolidated and discussed when the panel met on June 11, 2015. At that meeting, the progress was evaluated and new short-term goals proposed.Conclusions. Progress was made on 13 of the 20 short-term goals proposed in 2011. Significant advances were made in the characterization of middle ear gas exchange pathways, modeling eustachian tube function, and preliminary testing of treatments for eustachian tube dysfunction.Implications for Practice. In the future, imaging technologies should be developed to noninvasively assess middle ear/eustachian tube structure and physiology with respect to their role in otitis media pathogenesis. The new data derived from these structure/function experiments should be integrated into computational models that can then be used to develop specific hypotheses concerning otitis media pathogenesis and persistence. Finally, rigorous studies on medical or surgical treatments for eustachian tube dysfunction should be undertaken.

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Mastoid cavity obliteration: Our experience

Abstract: Incidence of discharge, debris, giddiness, pain was reduced in obliterated cavities. Healing of cavity was better in obliterated ears. Cavity obliterated with bone dust and flap had better and early epithelialisation as compared to cartilage.

Cited by 15 publications

References 4 publications

Surgical Outcome of Mastoid Cavity Obliteration Using Postauricular Composite Bone with Periosteum Flap

Surgical Outcome of Mastoid Cavity Obliteration Using Postauricular Composite Bone with Periosteum Flap

Comparison of the Recovery Results of Patients Who Underwent Canal Wall-Down Mastoidectomy with or Without Obliteration

Panel 2: Anatomy (Eustachian Tube, Middle Ear, and Mastoid—Anatomy, Physiology, Pathophysiology, and Pathogenesis)

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