Intact canal wall tympanomastoid surgery: 10 years experience.

310 cases of chronic middle ear disease were managed by Intact canal wall tympanomastoid surgery. Intact canal wall tympanomastoid surgery technique used in this study has been compared with the Jansen's classic ICW technique. A retrospective analysis of 310 cases of chronic middle ear pathology managed by Intact canal wall technique over a period of 10 years (January 1996 to December 2005) was conducted. Patients information was collected from the patients record. 310 patients, aged 5-60 years, were managed by Intact canal wall technique and followed for a minimum period of 5 years. The male:female ratio in our study was 1.25:1 (172 males:138 females). The ratio of adult to pediatric patients was 2.7:1 (226 adults:84 children). Out of 274 (88.4%) cases having a regular follow up, 196 (71.6%) were found to be stable. Postoperative retraction of the tympanic membrane was observed in 24 (8.8%) cases and was managed by the placement of ventilation tube. Secretory otitis media was seen in 14 (5%) cases and was managed by myringotomy and placement of ventilation tube. 17(12.4%) cases were revised including recurrent disease (10 cases), residual disease (6 cases), graft failure (12 cases), stenosis of the ear canal (4 cases), meatomastoid fistula (2 case). Our technique of Intact canal wall tympanomastoid surgery takes less time than the classic Jansen's technique, is easily reproducible and taught, is a single stage procedure and can be universally applied to various chronic middle ear pathologies as the primary treatment with low recidivism rate.