Comparative study of quality of life and surgical outcome in open mastoid cavity and mastoid cavity obliteration in canal wall down mastoidectomy
DOI:
https://doi.org/10.18203/issn.2454-5929.ijohns20231462Keywords:
Mastoid obliteration, Cholesteatoma, Canal wall down mastoidectomy, Bone dust, Bone pateAbstract
Background: Canal wall down mastoidectomy is a surgical technique used for the eradication of middle ear disease. The remaining large mastoid bowl is associated with a number of issues; one of the techniques that have been developed in order to avoid such problems is the obliteration of the mastoid cavity. Mastoid obliteration resulted in a decrease in the complications associated with the open mastoid cavity. The materials used for this reason are either biological or synthetic. Mastoid obliteration with synthetic materials is a valuable and safe surgical technique for patients who undergo canal wall down mastoidectomy.
Methods: This is a prospective study carried out in the department of otorhinolaryngology. Sample size: 30 patients out of which 15 were operated by Modified Radical Mastoidectomy with obliteration (Group A) and 15 were operated by Modified Radical Mastoidectomy without obliteration (Group B). Study design: single centre, longitudinal, prospective, two group, parallel, follow-up, randomly allocated statistical method and tools: Fischer’s Exact Test. Study period: August 2017 to August 2020.
Results: Study was divided in two groups, group A (modified radical mastoidectomy with obliteration) & group B (modified radical mastoidectomy without obliteration).
Conclusions: The incidence of pain, discharge, giddiness and wax formation was markedly reduced in obliterated cavities as compared to open cavities. Healing of the cavity as evidenced by epithelialization, at the end of 3 months, was better in obliterated ears. Patients with obliterated mastoid cavity required less cavity care, doctor dependence, frequent OPD visits.
References
Bennett M, Warren F, Haynes D. Indications and Technique in Mastoidectomy. Otolaryngol Clin North Am. 2018;39(6):1095-113.
Scott-Brown FC. Otorhinolaryngology, Head and Neck Surgery, 7th ed. England: Taylor Francis. 2011;93(7):559-63.
Zhang L. Therapeutic outcomes of canal wall up mastoidectomy in combination with Type I tympanoplasty in otitis media. Indian J Otol. 2016;32(3):565-9.
Harun A, Clark J, Semenov YR, Francis HW. The Role of Obliteration in the Achievement of a Dry Mastoid Bowl. Otol Neurotol. 2015;36(9):1510-7.
Mehta RP, Harris JP. Mastoid Obliteration. Otolaryngologic Clinics of North America. Otolaryngol Clin North Am. 2005;39(6):1129-42.
Monasta L, Ronfani L, Marchetti F, Montico M, Vecchi Brumatti L, Bavcar A, et al. Burden of Disease Caused by Otitis Media: Systematic Review and Global Estimates. PLoS one. 2012;7(4):e36226.
Yapijakis C. Hippocrates of Kos, the father of clinical medicine, and Asclepiades of Bithynia, the father of molecular medicine. Irish J Med Sci. 2009;23(4):507-14.
Gulya AJ, Minor LB, Poe D. Glasscock-Shambaugh Surgery of the Ear. USA: People's Medical Publishing House; 2010.
Mudry A. Annales d'oto-laryngologie et de chirurgie cervico faciale. Bullet de la Soc d'oto-laryngol. 2000;117(4):203-9.
Bento RF, Fonseca ACdO. A brief history of mastoidectomy. Int Arch Otorhinolaryngol. 2013;17(2):168-78.
William WM. Wilde: his contribution to otology. Irish J Med Sci. 2016;185(2):291-2.
Flint PW, Haughey BH, Robbins KT, Thomas JR, Niparko JK, Lund VJ, et al. Cummings Otolaryngology Head and Neck Surgery. USA: Elsevier Health Sciences; 2014.
Kurien G, Greeff K, Gomaa N, Ho A. Mastoidectomy and mastoid obliteration with autologous bone graft: a quality of life study. J Otolaryngol Head Neck Surg. 2013;42(1):49-53.
Rambo JH. Mastoid surgery: effect of retained mucosa on healing. Ann Otol Rhinol Laryngol. 1979;88:701-7.
Gopalakrishnan S, Chadha SK, Gopalan G, Ravi D. Role of mastoid obliteration in patients with persistent cavity problems following modified radical mastoidectomy. J Laryngol Otol. 2001;115(12):967-72.
Moffat DA, Gray RF, Irving RM. Mastoid obliteration using bone pâté. Clin Otolaryngol Allied Sci. 1994;19(2):149-57.
Parmekar S, Hazarika P, Viswanathan A, Balakrishnan R. Mastoid obliteration using temporo-parietal fascia flap-our experience. Indian J Otolaryngol Head Neck Surg. 1997;49(2):117-21.
van Hasselt CA. Mastoid surgery and the Hong Kong Flap. J Laryngol Otol. 2007;108(10):825-33.
Gibb AG, Tan KK, Sim RST. The Singapore swing. J Laryngol Otol. 2007;111(6):527-30.
Wadhwa V, Anand TS, Kumar S, Kathuria G, Rana I. Periosteo-Temporofascial flap for cavity obliteration - first Indian study. Indian J Otolaryngol Head Neck Surg. 2003;55(3):170-4.
Ramsey MJ, Merchant SN, McKenna MJ. Postauricular Periosteal-Pericranial Flap for Mastoid Obliteration and Canal Wall Down Tympanomastoidectomy. Otol Neurotol. 2004;25(6):873-8.
Beutner D, Stumpf R, Zahnert T, Huttenbrink KB. Long-term results following mastoid obliteration in canal wall down tympanomastoidectomy. Laryngo Rhino Otol. 2007;86(12):861-6.
Sun J, Sun J, Hu Y, Lv Q, Wang Y, Li X, et al. Canal wall-down mastoidectomy with mastoid obliteration for pediatric cholesteatoma. Acta Oto-Laryngol. 2010;130(2):259-62.
Singh M, Jain S, Rajput R, Khatua RK, Sharma D. Retrospective and prospective study of singapore swing method on healing of mastoid cavity. Indian J Otolaryngol Head Neck Surg. 2010;62(4):365-71.
Edfeldt L, Kinnefors A, Strömbäck K, Köbler S, Rask-Andersen H. Surgical treatment of paediatric cholesteatoma: Long-term follow up in comparison with adults. Int J Pediatr Otorhinolaryngol. 2012;76(8):1091-7.
Mokbel KM, Khafagy YW. Single flap with three pedicles, bone paté and split-thickness skin graft for immediate mastoid obliteration after canal wall down mastoidectomy. Eur Arch Oto-Rhino-Laryngol. 2012;269(9):2037.
Chhapola S, Matta I. Mastoid obliteration versus open cavity: a comparative study. Indian J Otolaryngol Head Neck Surg. 2014;66(1):207-13.
Standring S, Borley NR. Gray's Anatomy: The Anatomical Basis of Clinical Practice. USA: Churchill Livingstone Elsevier;2008.
Johnson JT, Rosen CA, Bailey BJ. Bailey's Head and Neck Surgery-otolaryngology. USA: Wolters Kluwer Health/Lippincott Williams & Wilkins;2014.
Sanna M, Sunose H. Middle Ear and Mastoid Microsurgery. Thieme. 2012.
Sanna M, Khrais T. Temporal Bone: A Manual for Dissection and Surgical Approaches. Thieme. 2011.
Brackmann D, Shelton C, Arriaga MA. Otologic Surgery. USA: Elsevier;2015.
Biswas A. Clinical Audio-vestibulometry for Otologists and Neurologists. India: Bhalani Publishing House;1995.
Shah AK, Patel S, Pawde A. Surgical outcome of mastoid cavity obliteration using postauricular composite bone with periosteum flap. Indian J Otolaryngol Head Neck Surg. 2017.
Beutner D, Helmstaedter V, Stumpf R, Beleites T, Zahnert T, Luers JC, et al. Impact of partial mastoid obliteration on caloric vestibular function in canal wall down mastoidectomy. Otol Neurotol. 2010;31(9):1399-403.
Jothiramalingam SB, Kumar D, Kumar P, Sasindran V, Kumar N. Atticoantral disease revisited. Indian J Otolaryngol Head Neck Surg. 2007;59(3):203-6.
Payal G, Pranjal K, Gul M, Mittal MK, Rai AK. Computed tomography in chronic suppurative otitis media: value in surgical planning. Indian J Otolaryngol Head Neck Surg. 2012;64(3):225-9.
Deshmukh S, Sharma A, Dabholkar J. Mastoid cavity obliteration: our experience. Polish Otolaryngol. 2012;66(6):379-8.
