Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-22T21:20:10.440Z Has data issue: false hasContentIssue false
  • English
  • Français

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]
Get access Rights & Permissions [Opens in a new window]

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

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

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