Relevant issues in revision canal-wall-down mastoidectomy

The role of canal-wall-down (CWD) versus intact-canal-wall (ICW) mastoidectomy in the treatment of chronic otitis media with or without cholesteatoma remains a debated issue. Although past conventional wisdom has held that CWD mastoid surgery leads to a “safe” ear and is technically less demanding t...

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Bibliographic Details
Published in:Otolaryngology-head and neck surgery 1999-07, Vol.121 (1), p.18-22
Main Authors: HARVEY, STEVEN A., FOX, MARY C.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Cholesteatoma, Middle Ear - surgery
Chronic Disease
Female
Humans
Male
Mastoid - surgery
Middle Aged
Otitis Media - surgery
Otologic Surgical Procedures - methods
Reoperation
Retrospective Studies
Treatment Failure
Treatment Outcome
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Summary:The role of canal-wall-down (CWD) versus intact-canal-wall (ICW) mastoidectomy in the treatment of chronic otitis media with or without cholesteatoma remains a debated issue. Although past conventional wisdom has held that CWD mastoid surgery leads to a “safe” ear and is technically less demanding than the more controversial ICW mastoidectomy, this is often not the case. Although our preference is an ICW technique when possible, 47 of 109 (43%) mastoid procedures for chronic otitis media performed between January 1993 and June 1996 involved a CWD mastoid cavity. More than two thirds of these procedures (32 of 47) represented revision surgery, the most common indication being a poorly contoured, preexisting CWD mastoidectomy with persistent otorrhea. A dry, well-epithelialized ear was obtained in 90% of cases. Our preferred method of ossicular reconstruction (double cartilage block ossiculoplasty) is detailed, and hearing results according to American Academy of Otolaryngology–Head and Neck Surgery guidelines are reported. (Otolaryngol Head Neck Surg 1999;121:18-22.)
ISSN:0194-5998
1097-6817
DOI:10.1016/S0194-5998(99)70116-6