Abstract
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 1 month and 3 months 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 31–40 year with its maximum incidence of 43.3%, Preop PTA value were almost equal in all group but on comparison at 1 month 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 3 month 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 3 months. outcome and quality of life was better and almost equal in muscle flap and bone dust material group as compared to hydroxyapatite group.
Similar content being viewed by others
References
Beales PH (1959) The problems of the mastoid cavity. J Larynol Otol 73:527–531
Males AG, Gray RF (1994) Mastoid surgery: quantifying the distress in a radical cavity. Clin Otolaryngol 19:194–198
Mosher HP (1911) A method of filling the excavated mastoid with a flap from the back of the auricle. Laryngoscope 21:1158–1163
Sade J, Weinberg J, Berco E, Brown M, Halvey A (1982) The marsupalised (radical) mastoid. J Laryngol Otol 96:869–875
Ojala K, Palva A (1982) Results of obliterative cholesteatoma surgery. Arch Otolaryngol Head Neck Surg 108:13
Moffat DA, Gray RE, Irving RM (1994) Mastoid obliteration using bone pate. Clin Otolaryngol 19:194–198
Plester D, Steinbach E (1977) Histological fate of tympanic membrane and ossicle homograft. Otolaryngol Clin N Am 10(3):487–499
Grote JJ, Van Butterswrik CA (1986) Reconstruction of posterior canal wall with hydroxypetite prosthesis. Ann Otorhinolaryngol 95(supp 123):10–12
Gantz BJ, Wilkinson EP, Hansen MR (2005) Canal wall reconstruction tympanomastoidectomy with mastoid obliteration. Laryngoscope 115:1734–1740
Goel A (1994) Extended vascularized temporalis muscle-fascia flap. Br J Neurosurg 8(6):731–733
East CA, Brough MD, Grant HR (1991) Mastoid obliteration with the temporoparietal fascia flap. J Laryngol Otol 105(6):417–420
Hartwein J, Hörmann K (1990) A technique for the reconstruction of the posterior canal wall and mastoid obliteration in radical cavity surgery. Otol Neurotol 11(3):169–173
Uçar C (2006) Canal wall reconstruction and mastoid obliteration with composite multi-fractured osteoperiosteal flap. Eur Arch Oto-Rhino-Laryngol Head Neck 263(12):1082–1086
Takahashi H, Iwanaga T, Kaieda S, Fukuda T, Kumagami H, Takasaki K, Hasebe S, Funabiki K (2007) Mastoid obliteration combined with soft-wall reconstruction of posterior ear canal. Eur Arch Otorhinolaryngol 264:867–871
Dornhoffer JL, Smith J, Richter G, Boeckmann J (2008) Impact on quality of life after mastoid obliteration. Laryngoscope 118(8):1427–1432
Mokbel KM, Khafagy YW (2012) Single flap with three pedicles, bone pate and split-thickness skin graft for immediate mastoid obliteration after canal wall down mastoidectomy. Eur Arch Otorhinolaryngol 269:2037–2041
Kurien G, Greeff K, Gomaa N, Ho A (2013) Mastoidectomy and mastoid obliteration with autologous bone graft: a quality-of-life study. J Otolaryngol-Head Neck Surg 42:1–7
Bernardeschi D, Nguyen Y, Mosnier I, Smail M, Ferrary E, Sterkers O (2014) Use of granules of biphasic ceramic in rehabilitation of canal wall down mastoidectomy. Eur Arch Otorhinolaryngol 271:59–64
Roux A, Bakhos D, Lescanne E, Cottier JP, Robier A (2015) Canal wall reconstruction in cholesteatoma surgeries: rate of residual. Eur Arch Otorhinolaryngol 272:2791–2797
Walker PC, Mowry SE, Hansen MR, Gantz BJ (2014) Long-term results of canal wall reconstruction tympanomastoidectomy. Otol Neurotol 35(6):954–960
Suzuki H, Ikezaki S, Imazato K, Koizumi H, Ohbuchi T, Hohchi N, Hashida K (2014) Partial mastoid obliteration combined with soft-wall reconstruction for middle ear cholesteatoma. Ann Otol Rhinol Laryngol 123(8):571–575
Blanco P, González F, Holguín J, Guerra C (2014) Surgical management of middle ear cholesteatoma and reconstruction at the same time. Colomb Med 45(3):127–131
Lee HJ, Chao JR, Yeon YK, Kumar V, Park CH, Kim HJ, Lee JH (2017) Canal reconstruction and mastoid obliteration using floating cartilages and musculoperiosteal flaps. Laryngoscope 127(5):1153–1160
Geerse S, Ebbens FA, De Wolf MJ, van Spronsen E (2017) Successful obliteration of troublesome and chronically draining cavities. J Laryngol Otol 131(2):138–143
Uluyol S, Ugur O, Arslan IB, Yagiz O, Gumussoy M, Cukurova I (2018) Effects of cavity reconstruction on morbidity and quality of life after canal wall down tympanomastoidectomy. Braz J Otorhinolaryngol 84:608–613
Elbary ME, Nasr WF, Sorour SS (2018) Platelet-rich plasma in reconstruction of posterior meatal wall after canal wall down mastoidectomy. Int Arch Otorhinolaryngol 22:103–107
Kim JS, Lim IG, Oh JH, Kim BG, Chang KH (2019) External auditory canal reconstruction and mastoid obliteration using modified Palva flap in canal wall down mastoidectomy with tympanoplasty. Ann Otol Rhinol Laryngol 128(6_suppl):69S-75S
Acknowledgements
The authors would like to thank the healthcare staff of the ENT ward.
Funding
None.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
None, declared.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Meena, S., Kumar, R. & Meena, R.K. Comparative Analysis of Various Materials Used for Mastoid Cavity Obliteration in Canal Wall Down Mastoid Surgery. Indian J Otolaryngol Head Neck Surg 76, 1586–1594 (2024). https://doi.org/10.1007/s12070-023-04364-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12070-023-04364-2