scholarly journals Mastoid cavity obliteration with bone dust: a retrospective study of 34 cases

2021 ◽  
Vol 7 (10) ◽  
pp. 1644
Author(s):  
Meenesh Juvekar ◽  
Baisali Sarkar
Keyword(s):  
Otitis Media ◽  
Mastoid Cavity ◽  
Canal Wall ◽  
Radical Mastoidectomy ◽  
Ossicular Reconstruction ◽  
Modified Radical Mastoidectomy ◽  
Canal Wall Down ◽  
Cavity Obliteration ◽  
Common Cavity

<p><strong>Background: </strong>Chronic suppurative otitis media leads to ear discharge with hearing loss with squamosal type often presents with cholesteatoma and mainstay of treatment is surgical. Modified radical mastoidectomy is the ideal surgical option in these cases but it results in open mastoid cavity formation with certain common cavity problems. This study done to find the results of mastoid cavity obliteration with autologous bone dust and how this technique is effective in avoiding long term cavity problems and assists in ossiculoplasty.</p><p><strong>Methods: </strong>This is a retrospective observational study done in a tertiary care hospital. Patients presented with squamosal type of chronic otitis media were operated for a canal wall down modified radical mastoidectomy.The mastoid cavity was obliterated using bone dust. A follow up of the patients was done and the healing of the cavity with the hearing result assessed.</p><p><strong>Results: </strong>The study includes total of 34 patients. 58.82% were male and 41.18% were female. All patients underwent canal wall down modified radical mastoidectomy and obliteration of the mastoid cavity was done with bone dust. The common cavity problems of discharge, debris were markedly reduced in an obliterated cavity with better healing of the cavity. The middle ear aeration was maintained assisting the ossicular reconstruction.</p><p><strong>Conclusions: </strong>This study showed that mastoid cavity obliteration with bone dust offers significant long term benefits in providing dry, well epithelized cavity at the same time assisting in ossicular reconstruction.</p>

scholarly journals Acetic Acid Instillation after Canal Wall Down Mastoidectomy

2015 ◽  
Vol 23 (3) ◽  
pp. 104-108
Author(s):  
Hamsa Shetty ◽  
Gangadhara K S
Keyword(s):  
Acetic Acid ◽  
Granulation Tissue ◽  
Mastoid Cavity ◽  
Canal Wall ◽  
Radical Mastoidectomy ◽  
Modified Radical Mastoidectomy ◽  
Group A ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy ◽  
Group B

Introduction: Persistent otorrhoea and granulation tissue in the mastoid cavity are common post-operative complications of Canal Wall Down Mastoidectomy. In order to avoid the same and to achieve a dry cavity instillation of acetic acid into the mastoid cavity during the post operative period is common practice. Materials and Methods In this study we assessed the results of 4% acetic acid instillation in varying quantity and frequency, in the ears after modified radical mastoidectomy. 40 Patients of chronic suppurative otitis media (atticoantral) / cholesteatoma, who underwent modified radical mastoidectomy during one and a half year period, were included in the study. The patients were divided into two groups; Group A with 30 patients and Group B with 10 patients, by simple randomization method. Group A patients were asked to instill 4% acetic acid approximately 10 to 12 drops (generously) into the mastoid cavity thrice a day for  8 weeks and were followed up every week.  10 patients  of Group B were asked to instill the same preparation only once weekly and followed up for the next 12 weeks.   Results: In Group A, dry mastoid cavity was achieved remarkably faster within six to eight weeks and in all the 30 patients. In Group B the results were delayed by up to 4 to 6 weeks in comparison to the Group A patients. Conclusion:             Though acetic acid instillation is known to help in achieving a dry cavity but a slightly higher concentration (4% acetic acid) used more frequently is highly effective in rendering dry cavity much earlier without proliferation of granulation tissue. 

Long-term outcome of ossiculoplasty using autogenous mastoid cortical bone

2014 ◽  
Vol 128 (10) ◽  
pp. 866-870 ◽  
Author(s):  
Z Yu ◽  
L Zhang ◽  
D Han
Keyword(s):  
Cortical Bone ◽  
Otitis Media ◽  
Chronic Otitis Media ◽  
Prosthetic Material ◽  
Canal Wall ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Canal Wall Down ◽  
Canal Wall Up

AbstractObjective:To observe the long-term outcome of ossiculoplasty using autogenous mastoid cortical bone in chronic otitis media in-patients.Methods:Sixty-one ears of 57 in-patients with chronic otitis media, with or without cholesteatoma, underwent type III tympanoplasty using autogenous mastoid cortical bone as the prosthetic material. Twenty-one ears were treated by canal wall down mastoidectomy and 40 ears by canal wall up mastoidectomy. The follow-up period was 3 to 6 years (average 4.2 years). Pure tone averages for thresholds at 0.5, 1, 2 and 3 kHz were calculated using standard conventional audiometry.Results:The pre-operative mean air–bone gap of 31.6 dB, for all ears, was reduced to 20.3 dB post-operatively. For the 40 canal wall up ears, this value decreased from 30.8 dB to 19.9 dB, and for the 21 canal wall down ears it decreased from 33.0 dB to 21.0 dB. The differences between the pre- and post-operative mean air–bone gap values were significant.Conclusion:No cases of extrusion, necrosis or resorption were exhibited for the autogenous mastoid cortical bone prosthesis. A significant hearing improvement was obtained in the majority of cases and this remained stable over time.

Soft-Wall Reconstruction of the Posterior External Ear Canal Wall

1986 ◽  
Vol 94 (3) ◽  
pp. 355-359 ◽  
Author(s):  
Peter G. Smith ◽  
Malcolm H. Stroud ◽  
Joel A Goebel
Keyword(s):  
Functional Results ◽  
Mastoid Cavity ◽  
Canal Wall ◽  
Ear Canal ◽  
Mastoid Obliteration ◽  
Simple Method ◽  
Acoustic Characteristics ◽  
Modified Radical Mastoidectomy ◽  
Soft Wall

A simple method of reconstructing a previously removed posterior ear canal with an autogenous, bilaminar membrane is described. The resulting air-filled mastoid cavity is an anatomic extension of the middle ear cleft and is separated from the ear canal by a functional barrier that is continuous with the tympanic membrane. The acoustic characteristics of an associated tympanoplasty are not significantly altered, and many of the problems that are associated with an exteriorized cavity are avoided. In contradistinction to other methods of mastoid obliteration or reconstruction, the semitransparent nature of the soft canal wall allows inspection of the underlying cavity for residual or recurrent disease. The technique can be used to repair either a newly created cavity or a previous radical (or modified radical) mastoidectomy defect. The functional results of thirty ears reconstructed in this fashion are detailed. A variable amount of soft-wall retraction was noted postoperatively in 47% of the ears; however, the long-term functional results in these cases remain satisfactory.

Subperiosteal Mastoid Abscesses in Chronic Suppurative Otitis Media

1988 ◽  
Vol 97 (4) ◽  
pp. 373-375 ◽  
Author(s):  
A. Olu Ibekwe ◽  
Benjamin C. C. Okoye
Keyword(s):  
Otitis Media ◽  
Acute Otitis Media ◽  
Chronic Otitis Media ◽  
Mastoid Cavity ◽  
Radical Mastoidectomy ◽  
Acute Mastoiditis ◽  
Suppurative Otitis Media ◽  
Modified Radical Mastoidectomy ◽  
Radiographic Investigation ◽  
The Ideal

In Europe and America, acute mastoiditis usually appears as a complication of acute otitis media, and some patients develop subperiosteal mastoid abscesses. In Nigeria, however, most subperiosteal mastoid abscesses develop from chronic otitis media with cholesteatoma. Of the 16 patients with subperiosteal mastoid abscesses discussed, 11 (69 %) had cholesteatoma and only five (31 %) had granulation tissue in the mastoid cavity. The ideal treatment for these cases is modified radical mastoidectomy. Radiographic investigation of the mastoid can be useful in the diagnosis of cholesteatoma in the presence of a subperiosteal mastoid abscess.

scholarly journals Mastoid Obliteration Using Bioactive Glass—Our Experience

2021 ◽  
Author(s):  
Anand Velusamy ◽  
Nazrin Hameed ◽  
Aishwarya Anand
Keyword(s):  
Postoperative Complications ◽  
Bioactive Glass ◽  
Secondary Outcome ◽  
Mastoid Cavity ◽  
Canal Wall ◽  
Mastoid Obliteration ◽  
Posterior Canal ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy ◽  
Cavity Obliteration

Abstract Aims The aim of this study was to evaluate the surgical outcome of cavity obliteration with bioactive glass in patients with cholesteatoma undergoing canal wall down mastoidectomy with reconstruction of the canal wall. Materials and Methods A prospective study was conducted over a period of 3 years on 25 patients who underwent mastoid obliteration with bioactive glass following canal wall down mastoidectomy for cholesteatoma. The primary outcome measure was the presence of a dry, low-maintenance mastoid cavity that was free of infection, assessed, and graded according to the grading system by Merchant et al at the end of 1 and 6 months postoperatively. Secondary outcome measures included presence of postoperative complications like wound infection, posterior canal wall bulge, and residual perforation. Results Out of the 25 patients on whom this study was conducted, at the end of 1 month 60% had a completely dry ear, 28% of patients had grade 1, and 12% had grade 2 otorrhea at the end of the first month. At the end of 6 months, 72% had a completely dry ear, while 20% had grade 1 and 8% had grade 2 otorrhea. There were no cases with grade 3 otorrhea during the entire follow-up period. Postoperative complications of the posterior canal bulge were noted in two patients (8%), and one patient (4%) had a residual perforation. Conclusion Mastoid cavity obliteration with bioactive glass is an effective technique to avoid cavity problems.

scholarly journals Cholesteatoma surgery by open technique with reconstruction together with same session ossiculoplasty

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Mohammed Saad Hasaballah ◽  
Peter Milad ◽  
Ossama Mustafa Mady ◽  
Ahmed Abdelmoneim Teaima
Keyword(s):  
Complete Removal ◽  
Mastoid Cavity ◽  
Canal Wall ◽  
Open Technique ◽  
Viable Option ◽  
Effective Option ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy ◽  
Cavity Obliteration ◽  
Cholesteatoma Surgery

Abstract Background This study was designed to evaluate the effect of mastoid cavity obliteration with bone chips and reconstruction of canal wall with tragal cartilage after canal wall down tympanomastoidectomy with cartilage ossiculoplasty in the same session. Sixty-three patients with cholesteatoma underwent the technique mentioned above; patients were followed for 1 year postoperative. Results No cavity problems, median preoperative air bone gap was 32.86 ± 6.24 db, while the median postoperative air bone gap was 21.67 ± 5.99 db. Conclusions Canal wall down mastoidectomy with obliteration of mastoid cavity is an effective option for the complete removal of cholesteatoma and same session cartilage ossiculoplasty is a viable option.

scholarly journals Management of labyrinthine fistula using Surdille flap

2017 ◽  
Vol 4 (1) ◽  
pp. 32
Author(s):  
Rashmi P. Rajashekhar ◽  
Vinod V. Shinde
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Semicircular Canals ◽  
Canal Wall ◽  
Endochondral Bone ◽  
Labyrinthine Fistula ◽  
Modified Radical Mastoidectomy ◽  
Canal Wall Down ◽  
Vestibular Symptoms ◽  
Postoperative Vertigo

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Labyrinthine fistula (LF) is the most common intra-temporal complication of squamosal chronic otitis media represents an erosive loss of endochondral bone overlying the semicircular canals without loss of perilymph. Main treatment of LF is surgical. The aim of our study is to discuss its incidence and sex ratio. The main objective is to describe the audio-vestibular results after closure of labyrinthine fistula by our technique using surdille flap. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">234 patients with squamosal chronic otitis media presented to our institution in a period of 24 months. Out of 234 patients, 22 patients were having labyrinthine fistula. Eleven patients had fistula test positive. Rest eleven patients were found to have LF intra-operatively. All patients underwent canal wall down modified radical mastoidectomy (MRM). Treatment of LF was done surgically by using surdille flap in all the cases. Post operatively Audio-vestibular results of labyrinthine fistula surgery by our technique were studied.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">The results show that the cholesteatoma matrix can be removed from the fistula. Removal of the fistula generally improves the vestibular symptoms. In all patients canal wall down procedure was done with surdille flap seal over LF. In our study, incidence of LF was 9.40% and none of the patients ended up with postoperative deafness. Hearing improved in 36.40% patients whereas it remained unchanged in rest of the cases. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Labyrinthine fistula, very commonly seen in the lateral semicircular canal has incidence of 5-10% reported in many studies. We demonstrated that open technique with removal of matrix and sealing with three layers may be a valuable choice for the surgical treatment of LF with little risk for cochlea-vestibular functions. Advantage of using surdille flap (sealing the fistula with three layers) is that it decreases the possibility of postoperative vertigo.</span></p>

scholarly journals TO EVALUATE THE HEARING RESULTS FOLLOWING OSSICULAR RECONSTRUCTION IN PATIENT WITH CHRONIC SUPPURATIVE OTTITIS MEDIA.

2019 ◽  
Vol 3 (4) ◽  
Author(s):  
Arjun Nath Yogee ◽  
Navneet Mathur
Keyword(s):  
Otitis Media ◽  
Chronic Infection ◽  
Chronic Otitis Media ◽  
Canal Wall ◽  
Hearing Results ◽  
Ossicular Reconstruction ◽  
Ear Ossicles ◽  
Life Threatening ◽  
Canal Wall Down ◽  
A Prospective Study

Background: Chronic otitis media erodes the bone, destroys the ossicles and has the potential to cause life threatening complications. Methods: This is a prospective study involving patients with chronic otitis media. 120 patients were included and all of them are subjected to ossicular reconstruction either by canal wall down or intact canal wall surgery. Results: As per Wehr's classification 80% of patients in Group 1A have got improvement and 20% have failed to gat improved in A-B gap, in Group 1B 20% -have failed to get improved in A-B gap and in Group 1C, 30% have failed to get improved in A-B gap. 70% of patients in Group 2A have got improvement and 30% have failed to gat improved in A-B gap, in Group 2B 80% of patients have got improvement and 20% -have failed to get improved in A-B gap and in Group 2C 70% of patients have got improvement and 30% have failed to get improved in A-B gap. Conclusion: All the three modalities gave statistically significant improvement (p < 0.001) in A-B gap leading to improvement in hearing but among the three groups there was no statistically significant (p > 0.05) difference found in improvement of A-B gap. Keywords: Chronic Infection, Middle Ear, Ossicles.

scholarly journals Combined conchal cartilage islet-periosteum and posterior based pedicled flap obliteration: a comparison with unobliterated mastoid cavities

2020 ◽  
Vol 6 (11) ◽  
pp. 1991
Author(s):  
Arindam Das ◽  
Sandipta Mitra ◽  
Sayan Hazra ◽  
Arunabha Sengupta
Keyword(s):  
Chronic Otitis Media ◽  
Pedicled Flap ◽  
Open Cavity ◽  
Mastoid Cavity ◽  
Volume Discharge ◽  
Cavity Volume ◽  
Canal Wall ◽  
Conchal Cartilage ◽  
Canal Wall Down ◽  
Cavity Obliteration

<p><strong>Background:</strong> Aim of the study was to compare the outcomes of a new technique of mastoid cavity obliteration with open mastoid cavity.</p><p><strong>Methods:</strong> 90 patients diagnosed with chronic otitis media (active squamosal variety) and planned to undergo surgery between 2016-2018 were randomly assigned into two groups of 45 patients. One group underwent canal wall down matoidectomy followed by cavity obliteration with posteriorly based vascularised flap with mastoid cortex periosteum plus conchal cartilage composite graft and the other underwent the same surgery but without any obliteration. The two groups were compared in terms of cavity volume, discharge, epithelisation, wax formation, subjective sensation of vertigo and post-operative air-bone gap at 1 year.</p><p><strong>Results:</strong> Cavity obliteration in post-canal wall down setting significantly reduced the post-operative cavity volume and need for cavity debridement with better epithelisation, less incidence of discharge, vertigo on caloric stimulation when compared to open cavity. The post-operative air-bone gap in obliterated cavities was better but not statistically significant.</p><p><strong>Conclusion: </strong>Cavity obliteration has definite advantages over open cavity in terms of healing but no significant differences in long-term audiological outcomes.</p>

scholarly journals A rare case of Bezold’s abscess presenting as parapharyngeal abscess

2015 ◽  
Vol 1 (1) ◽  
pp. 48 ◽  
Author(s):  
Ameya Bihani ◽  
Jyoti P. Dabholkar
Keyword(s):  
Otitis Media ◽  
Rare Complication ◽  
Chronic Suppurative Otitis Media ◽  
Canal Wall ◽  
Radical Mastoidectomy ◽  
Suppurative Otitis Media ◽  
Incision And Drainage ◽  
Parapharyngeal Abscess ◽  
Modified Radical Mastoidectomy ◽  
Anterior Belly

<p class="abstract"><span lang="EN-US">Bezold’s abscess is a very rare complication of unsafe chronic suppurative otitis media. The diagnosis of Bezold’s abscess is clinched by the presence of inflammation which is tracking down the anterior belly of digastrics and sternocleidomastoid. Surgery constituting incision and drainage of abscess with canal wall modified radical mastoidectomy is treatment of choice. We hereby present a case of 42 year male presenting with parapharyngeal abscess (Bezold’s abscess) which was secondary to unsafe chronic suppurative otitis media.</span></p>

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