Ho Jun Lee1,2, Janet Ren Chao3, Yeung Kyu Yeon2, Vijay Kumar2, Chan Hum Park1,2, Hyung-Jong Kim1,2, Jun Ho Lee1,2. 1. Department of Otorhinolaryngology-Head and Neck Surgery, Chuncheon Sacred Heart Hospital, School of Medicine, Chuncheon, Kangwon, Republic of Korea. 2. Nano-Bio Regenerative Medical Institute, Hallym University, Chuncheon, Kangwon, Republic of Korea. 3. School of Medicine, George Washington University, Washington, DC, U.S.A.
Abstract
OBJECTIVES: To reduce the mastoid cavity-associated problems secondary to canal wall down mastoidectomy, we designed a new surgical procedure that includes canal wall reconstruction using free-floating cartilages and double musculoperiosteal flaps. STUDY DESIGN: Retrospective study. MATERIALS AND METHODS: Thirty-three patients were enrolled in this study. Preoperative and postoperative pure tone audiometry/speech discrimination score and postoperative status (complications and EAC status) were analyzed. RESULTS: Air conduction thresholds were statistically improved (P = 0.008). The air-bone gap was significantly reduced following surgery (P = 0.001). There were no other major complications in any of the patients. Long-term follow-up demonstrated gradual widening of the neo-EAC in 18 patients (54.5%) but normal contour of the neo-EAC in the other 13 patients (39.4%). In just one case did the neo-EAC become extremely widened. CONCLUSION: Mastoid obliteration and canal wall reconstruction using free-floating cartilages and double musculoperiosteal flaps is very useful to achieve optimal surgical view, eliminate the middle ear pathology, and prevent recurrence of cholesteatoma and cavity problem. LEVEL OF EVIDENCE: 4. Laryngoscope, 127:1153-1160, 2017.
OBJECTIVES: To reduce the mastoid cavity-associated problems secondary to canal wall down mastoidectomy, we designed a new surgical procedure that includes canal wall reconstruction using free-floating cartilages and double musculoperiosteal flaps. STUDY DESIGN: Retrospective study. MATERIALS AND METHODS: Thirty-three patients were enrolled in this study. Preoperative and postoperative pure tone audiometry/speech discrimination score and postoperative status (complications and EAC status) were analyzed. RESULTS: Air conduction thresholds were statistically improved (P = 0.008). The air-bone gap was significantly reduced following surgery (P = 0.001). There were no other major complications in any of the patients. Long-term follow-up demonstrated gradual widening of the neo-EAC in 18 patients (54.5%) but normal contour of the neo-EAC in the other 13 patients (39.4%). In just one case did the neo-EAC become extremely widened. CONCLUSION:Mastoid obliteration and canal wall reconstruction using free-floating cartilages and double musculoperiosteal flaps is very useful to achieve optimal surgical view, eliminate the middle ear pathology, and prevent recurrence of cholesteatoma and cavity problem. LEVEL OF EVIDENCE: 4. Laryngoscope, 127:1153-1160, 2017.
Authors: M Tayyar Kalcioglu; Ali Ozerk; Oguz Kadir Egilmez; Numan Kokten; Lokman Uzun; Yuksel Toplu; Muhammet Tekin Journal: Medeni Med J Date: 2019-12-26