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Surgical management of troublesome mastoid cavities

Published online by Cambridge University Press:  09 November 2010

M Yung ,
P Tassone ,
I Moumoulidis  and
S Vivekanandan
M Yung*
Affiliation:
Department of Otolaryngology, The Ipswich Hospital NHS Trust, UK
P Tassone
Affiliation:
Department of Otolaryngology, The Ipswich Hospital NHS Trust, UK
I Moumoulidis
Affiliation:
Department of Otolaryngology, The Ipswich Hospital NHS Trust, UK
S Vivekanandan
Affiliation:
Department of Otolaryngology, The Ipswich Hospital NHS Trust, UK
*
Address for correspondence: Mr Matthew Yung, Department of Otolaryngology, The Ipswich Hospital NHS Trust, Heath Road, Ipswich IP5 4PD, UK Fax: +44 (0)1473 793576 E-mail: [email protected]
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Abstract

Objective:

To examine the reasons for discharging mastoid cavities, the operative findings during revision surgery, and the medium-term outcome.

Patients:

One hundred and forty revision mastoidectomies in 131 patients were studied. Post-operatively, patients were followed up at three, six and 12 months and then yearly.

Intervention:

A variety of techniques were performed. Over 80 per cent of ears were treated with mastoid obliteration. Concomitant hearing restorative procedures were carried out in one-third of the ears.

Results:

The mastoid cavities were troublesome because of large cavity size, bony overhang, residual infected mastoid cells, the presence of cholesteatoma or perforations, and/or inadequate meatoplasty. One year after revision mastoidectomy, over 95 per cent of the ears had become completely ‘dry’ and water-resistant. Overall, 50.9 per cent of the ears had a 12-month post-operative air–bone gap of 20 dB or less.

Conclusion:

Revision mastoidectomy has a high success rate in converting troublesome mastoid cavities into dry, water-resistant ears.

Keywords

MastoidCholesteatomaRevision SurgeryOtologic Surgical Procedures
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 3 , March 2011 , pp. 221 - 226
Copyright
Copyright © JLO (1984) Limited 2010

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References

1Roden, D, Honrubia, VF, Wiet, R. Outcome of residual cholesteatoma and hearing in mastoid surgery. J Otolaryngol 1996;25:178–81Google ScholarPubMed
2Khalil, HS, Windle-Taylor, PC. Canal wall down mastoidectomy: a long term commitment to the outpatients? BMC Ear, Nose and Throat Disorders 2003;3:1. http://www.biomedcentral.com/1472-6815/3/1CrossRefGoogle Scholar
3Shaan, M, Landolfi, M, Taibah, A, Russo, A, Szymanski, M, Sanna, M. Modified Bondy technique. Am J Otol 1995;16:695–7Google ScholarPubMed
4Yung, MW. The use of hydroxyapatite granules in mastoid obliteration. Clin Otol 1996;21:480–4CrossRefGoogle ScholarPubMed
5Yung, M, Smith, P. Mid-temporal pericranial and inferiorly based periosteal flaps in mastoid obliteration. Otolaryngol Head Neck Surg 2007;137:906–12CrossRefGoogle ScholarPubMed
6Committee on Hearing and Equilibrium guidelines for the evaluation of results of treatment of conductive hearing loss. Otolaryngol Head Neck Surg 1995;113:186–7CrossRefGoogle Scholar
7Yung, MM, Karia, KR. Mastoid obliteration with hydroxyapatite – the value of high resolution CT scanning in detecting recurrent cholesteatoma. Clin Otolaryngol 1997;22:553–7CrossRefGoogle ScholarPubMed
8Stangerup, SE, Drozdziewicz, D, Tos, M, Hogaard-Jensen, A. Recurrence of attic cholesteatoma: different methods of estimating recurrence rate. Otolaryngol Head Neck Surg 2000;123:283–287Google Scholar
9Veldman, JE, Braunius, WW. Revision surgery for chronic otitis media: a learning experience. Report on 389 cases with a long-term follow-up. Ann Otol Rhinol Laryngol 1998;107:486–91CrossRefGoogle ScholarPubMed
10Sheehy, JL, Robinson, JV. Cholesteatoma surgery at the otologic medical group. Residual and recurrent disease. A report on 307 revision operations. Am J Otol 1982;3:209–15Google ScholarPubMed
11Nadol, JB. Causes of failure of mastoidectomy for chronic otitis media. Laryngoscope 1985;95:410–13CrossRefGoogle ScholarPubMed
12Mills, RP. Surgical management of the discharging mastoid cavity. J Laryngol Otol 1988;16:1–6CrossRefGoogle ScholarPubMed
13Filipo, R, Maurizio, B. Rehabilitation of radical mastoidectomy. Am J Otol 1986;7:248–52Google ScholarPubMed
14Bercin, S, Kutluhan, A, Bozdemir, , Yalciner, G, Sari, N, Karamese, O. Results of revision mastoidectomy. Acta Otolaryngol 2009;129:138–41CrossRefGoogle ScholarPubMed