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Mastoid and Epitympanic Obliteration in Canal Wall Up Mastoidectomy for Prevention of Retraction Pocket

Authors
 Won Sang Lee  ;  Jae Young Choi  ;  Sung Huhn Kim  ;  Sang Ho Jung  ;  Eun Jin Son  ;  Mee Hyun Song 
Citation
 OTOLOGY & NEUROTOLOGY, Vol.26(6) : 1107-1111, 2005 
Journal Title
OTOLOGY & NEUROTOLOGY
ISSN
 1531-7129 
Issue Date
2005
MeSH
Adolescent ; Adult ; Aged ; Bone Transplantation* ; Child ; Cholesteatoma, Middle Ear/surgery* ; Female ; Follow-Up Studies ; Humans ; Male ; Mastoid/surgery* ; Middle Aged ; Postoperative Complications/etiology* ; Reoperation ; Risk Factors ; Secondary Prevention ; Surgical Flaps* ; Tympanoplasty/methods*
Keywords
16272924
Abstract
OBJECTIVE: To evaluate the surgical outcome in patients who have undergone mastoid and epitympanic obliteration technique.
STUDY DESIGN: Retrospective review.
SETTING: Tertiary care referral center.
PATIENTS: The study group included 151 patients with cholesteatoma who underwent mastoid and epitympanic obliteration technique. This technique was applied to cases who had a strong chance of recurrent retraction pocket and cholesteatoma formation, including those patients with an adhesive drum indicating poor eustachian tube function (n = 52) and patients with a destructive scutum (n = 68). Thirty-one patients had both an adhesive drum and a destructive scutum.
INTERVENTION: The connection between the mastoid cavity and the middle ear was blocked by obliterating the epitympanum and antrum with bone pate and the remaining mastoid cavity with abdominal fat.
MAIN OUTCOME MEASURES: The postoperative drum state, the incidence of retraction pocket formation and cholesteatoma recurrence, the surgical complications of obliteration, and the hearing outcome.
RESULTS: In 114 of 151 patients (75.4%), the middle ear was well healed and well aerated. The retraction pocket formation or cholesteatoma recurrence did not develop in any subject. Postauricular skin depression was the most common complication of this technique (n = 31 [20.5%]). In three patients (2.0%), the bone pate used for obliteration was infected. Of the 56 cases who underwent a staged operation to regain their hearing, 37 resulted in a postoperative air-bone gap less than 20 dB hearing level.
CONCLUSION: Mastoid and epitympanic obliteration is an effective option for preventing a retraction pocket and cholesteatoma recurrence in patients with a poorly functioning eustachian tube or a defective scutum, while preserving the same advantage of the canal wall up technique.
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00129492-200511000-00003&LSLINK=80&D=ovft
DOI
OAK-2005-02213
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학교실) > 1. Journal Papers
Yonsei Authors
Lee, Won Sang(이원상)
Choi, Jae Young(최재영) ORCID logo https://orcid.org/0000-0001-9493-3458
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/114764
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