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Reconstruction and Obliteration of the Mastoid Cavity

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Textbook of Otitis Media
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Abstract

Mastoidectomy, in various forms, is an essential aspect of otological surgery; however, some of these procedures generate undesired consequences ranging from cosmetic issues to functional aspects that lead to chronic infection and discomfort. In certain instances, the negative sequelae of mastoidectomy prompts surgical correction. The purpose of this chapter is to present various surgical options that are available to minimize or reverse the negative impact of mastoidectomy surgery via either reconstructive or obliterative techniques.

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References

  1. Mastoid Buffering Properties: I. Gas Partial Pressures | Ovid. 2021. https://oce.ovid.com/article/00000627-199908080-00007.

  2. Yanagihara N, Hinohira Y, Sato H. Mastoid cortex plasty using bone pate. Otol Neurotol. 2002;23(4):422–4.

    Article  PubMed  Google Scholar 

  3. Virapongse C, Sarwar M, Bhimani S, Sasaki C, Shapiro R. Computed tomography of temporal bone pneumatization: 1. Normal pattern and morphology. Am J Roentgenol. 1985;145(3):473–81.

    Article  Google Scholar 

  4. Schulter-ellis FP. Population differences in cellularity of the mastoid process. Acta Otolaryngol. 1979;87(3–6):461–5.

    Article  PubMed  Google Scholar 

  5. Tos M, Stangerup S-E, Hvid G. Mastoid pneumatization: evidence of the environmental theory. Arch Otolaryngol. 1984;110(8):502–7.

    Article  PubMed  Google Scholar 

  6. Toros SZ, Habesoglu TE, Habesoglu M, Bolukbasi S, Naiboglu B, Karaca CT, et al. Do patients with sclerotic mastoids require aeration to improve success of tympanoplasty? Acta Otolaryngol. 2010;130(8):909–12.

    Article  PubMed  Google Scholar 

  7. Sadé J. The correlation of middle ear aeration with mastoid pneumatization. Eur Arch Otorhinolaryngol. 1992;249(6):301–4.

    Article  PubMed  Google Scholar 

  8. Paparella MM, Kim CS. Mastoidectomy update. Laryngoscope. 1977;87(12):1977–88.

    Article  PubMed  Google Scholar 

  9. Yanagihara N, Komori M, Hinohira Y. Total mastoid obliteration in staged canal-up tympanoplasty for cholesteatoma facilitates tympanic aeration. Otol Neurotol. 2009;30(6):766–70.

    Article  PubMed  Google Scholar 

  10. Thomas JMN, Gluth MB. Reconstruction of mastoid cortex defects with hydroxyapatite cement for negative sequelae of mastoidectomy. Ann Otol Rhinol Laryngol. 2021;130(4):338–42.

    Article  PubMed  Google Scholar 

  11. Kveton JF, Coelho DH. Hydroxyapatite cement in temporal bone surgery: a 10 year experience. Laryngoscope. 2004;114(1):33–7.

    Article  PubMed  Google Scholar 

  12. Kim HH, Wilson DF. Titanium mesh for functional reconstruction of the mastoid cortex after mastoidectomy. Otol Neurotol. 2006;27(1):33–6.

    Article  PubMed  Google Scholar 

  13. Sun J-Q, Sun J-W, Hou X-Y, Bie Y-Z, Chen J-W. Using autogenous mastoid cortical bone cap to cover the mastoidectomy defect during cochlear implantation. Int J Pediatr Otorhinolaryngol. 2015;79(3):419–22.

    Article  PubMed  Google Scholar 

  14. Gluth MB, Metrailer AM, Dornhoffer JL, Moore PC. Patterns of failure in canal wall down mastoidectomy cavity instability. Otol Neurotol. 2012;33(6):998–1001.

    Article  PubMed  Google Scholar 

  15. Males AG, Gray RF. Mastoid misery: quantifying the distress in a radical cavity. Clin Otolaryngol Allied Sci. 1991;16(1):12–4.

    Article  PubMed  Google Scholar 

  16. Sadé J, Weinberg J, Berco E, Brown M, Halevy A. The marsupialized (radical) mastoid. J Laryngol Otol. 1982;96(10):869–75.

    Article  PubMed  Google Scholar 

  17. Wormald PJ, Nilssen ELK. The facial ridge and the discharging mastoid cavity. Laryngoscope. 1998;108(1):92–6.

    Article  PubMed  Google Scholar 

  18. Dornhoffer JL, Friedman AB, Gluth MB. Management of acquired cholesteatoma in the pediatric population. Curr Opin Otolaryngol Head Neck Surg. 2013;21(5):440–5.

    Article  PubMed  Google Scholar 

  19. Dornhoffer JL. Surgical modification of the difficult mastoid cavity. Otolaryngol Head Neck Surg. 1999;120(3):361–7.

    Article  PubMed  Google Scholar 

  20. Hung T, Leung N, Hasselt CA van, Liu KC, Tong M. Long-term outcome of the Hong Kong vascularized, Pedicled temporalis fascia flap in reconstruction of mastoid cavity. Laryngoscope 2007;117(8):1403–1407.

    Google Scholar 

  21. O’sullivan PG, Atlas MD. Use of soft tissue vascular flaps for mastoid cavity obliteration. Laryngoscope. 2004;114(5):957–9.

    Article  PubMed  Google Scholar 

  22. Ramsey MJ, Merchant SN, McKenna MJ. Postauricular periosteal-pericranial flap for mastoid obliteration and canal wall down tympanomastoidectomy. Otol Neurotol. 2004;25(6):873–8.

    Article  PubMed  Google Scholar 

  23. Singh V, Atlas M. Obliteration of the persistently discharging mastoid cavity using the middle temporal artery flap. Otolaryngol Head Neck Surg. 2007;137(3):433–8.

    Article  PubMed  Google Scholar 

  24. van Hasselt CA. Mastoid surgery and the Hong Kong flap. J Laryngol Otol. 1994;108(10):825–33.

    Article  PubMed  Google Scholar 

  25. Wilson KF, Hoggan RN, Shelton C. Tympanoplasty with intact canal wall mastoidectomy for cholesteatoma: long-term surgical outcomes. Otolaryngol Head Neck Surg. 2013;149(2):292–5.

    Article  PubMed  Google Scholar 

  26. Leatherman BD, Dornhoffer JL. The use of demineralized bone matrix for mastoid cavity obliteration. Otol Neurotol. 2004;25(1):22–6.

    Article  PubMed  Google Scholar 

  27. Talmage GD, Sunde J, Walker DD, Atlas MD, Gluth MB. Anatomic basis of the middle temporal artery periosteal rotational flap in otologic surgery. Laryngoscope. 2016;126(6):1426–32.

    Article  PubMed  Google Scholar 

  28. Beutner D, Helmstaedter V, Stumpf R, Beleites T, Zahnert T, Luers JC, et al. Impact of partial mastoid obliteration on caloric vestibular function in canal wall down mastoidectomy. Otol Neurotol. 2010;31(9):1399–403.

    Article  PubMed  Google Scholar 

  29. Dornhoffer JL, Smith J, Richter G, Boeckmann J. Impact on quality of life after mastoid obliteration. Laryngoscope. 2008;118(8):1427–32.

    Article  PubMed  Google Scholar 

  30. Gluth MB, Friedman AB, Atcherson SR, Dornhoffer JL. Hearing aid tolerance after revision and obliteration of canal wall down mastoidectomy cavities. Otol Neurotol. 2013;34(4):711–4.

    Article  PubMed  Google Scholar 

  31. Li PMMC, Linos E, Gurgel RK, Fischbein NJ, Blevins NH. Evaluating the utility of non–echo-planar diffusion-weighted imaging in the preoperative evaluation of cholesteatoma: a meta-analysis. Laryngoscope. 2013;123(5):1247–50.

    Article  PubMed  Google Scholar 

  32. Gluth MB, Tan BYB, Santa Maria PL, Atlas MD. Unique microbiology of chronically unstable canal wall down tympanomastoid cavities: considerations for surgical revision. J Laryngol Otol. 2013;127(5):458–62.

    Article  PubMed  Google Scholar 

  33. Palva T. Reconstruction of ear canal in surgery for chronic ear. Arch Otolaryngol. 1962;75(4):329–34.

    Article  PubMed  Google Scholar 

  34. Fagan PA, Rodrigues SJ. Middle temporal artery flap in mastoid surgery. Otol Neurotol. 2004;25(3):242–4.

    Article  PubMed  Google Scholar 

  35. Turner J. Symposium on ear surgery. I. Soft tissue technique in musculoplasty obliteration of mastoidectomy cavities. Laryngoscope. 1972;82(7):1145–59.

    Article  PubMed  Google Scholar 

  36. Cheney ML, Megerian CA, Brown MT, Mckenna MJ. Mastoid obliteration and lining using the temporoparietal fascial flap. Laryngoscope. 1995;105(9):1010–3.

    Article  PubMed  Google Scholar 

  37. East CA, Brough MD, Grant HR. Mastoid obliteration with the temporoparietal fascia flap. J Laryngol Otol. 1991;105(6):417–20.

    Article  PubMed  Google Scholar 

  38. Gibb AG, Tan KK, Sim RST. The Singapore swing. J Laryngol Otol. 1997;111(6):527–30.

    Article  PubMed  Google Scholar 

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Gluth, M.B., Judd, R.T. (2023). Reconstruction and Obliteration of the Mastoid Cavity. In: Goycoolea, M.V., Selaimen da Costa, S., de Souza, C., Paparella, M.M. (eds) Textbook of Otitis Media. Springer, Cham. https://doi.org/10.1007/978-3-031-40949-3_63

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  • DOI: https://doi.org/10.1007/978-3-031-40949-3_63

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-40948-6

  • Online ISBN: 978-3-031-40949-3

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