Fifty four of 983 patients who underwent CWD mastoidectomy plus mastoid cavity obliteration with cartilage and who were followed up regularly were selected and evaluated retrospectively. The database included data of 983 patients who underwent surgery due to chronic otitis media, performed by the same surgeon between January 2000 and June 2012. Informed consent was taken from the patients. The research protocol used in this study was approved by the Istanbul Medeniyet University, Goztepe Training and Research Hospital, Clinical Studies Ethic Committee, on Jwith decision no. In the present study, we described our technique and discussed the mid-term results of patients who had mastoid cavity obliteration with cartilage graft. To date, the results of mastoid obliteration with different materials have been reported. In some of the applications biologic autogenous flaps and graft materials have been used in combination as musculoperiosteal flap plus bone pate or cartilage plus musculoperiosteal flap 12, 13.
#Mastoid obliteration free#
Since then, various materials have been used for obliteration, that are divided into two categories as free grafts (biologic and non-biologic) such as cartilage, fat tissue, fascia, hydroxyapatite crystals, and local flaps such as Palva flap (musculoperiosteal flap), temporoparietal fascia flap, and postauricular myocutaneous flap 6- 12. Mosher 5 first introduced the concept of mastoid cavity obliteration using a postauricular soft tissue flap in 1911. To eliminate cavity-related problems and improve the stability of the cavity, mastoid obliteration techniques were introduced. However, it can also result in the formation of an unnatural, anatomically and physiologically unsatisfactory mastoid cavity and cavity related problems 3, 4. The recidivism rate can be reduced to as low as 2% with the CWD technique 1. In CWD technique, the posterior canal wall is removed, enhancing exposure of the entire epitympanum and middle ear and helping to ensure complete eradication of the pathology. The main disadvantage of this technique is a possiblly higher rate of residual disease therefore, many authors prefer the CWD technique 1, 2. The CWU technique preserves the anatomy of the posterior canal wall, thus avoiding the risk of recurrent cavity infections and eliminating the need for periodic cavity cleaning. This goal has been achieved consistently using canal wall down (CWD) and canal wall up (CWU) techniques. The primary aim in the surgical management of cholesteatoma is creation of a safe, dry ear by eradicating the disease and, if necessary, altering the anatomy to prevent recurrence. J Int Adv Otol 2019 15(3): 400-4.Surgery is accepted as the mainstay in the management of cholesteatoma. Mastoid Obliteration with Synthetic Materials: A Review of the Literature. The bioactive glass appears to be the most reliable synthetic material.Ĭite this article as: Skoulakis C, Koltsidopoulos P, Iyer A, Kontorinis G. On the basis of the available limited literature, it seems that mastoid obliteration with synthetic materials is a valuable and safe surgical technique for patients who undergo canal wall down mastoidectomy. Mastoid obliteration resulted in a decrease in the complications associated with the open mastoid cavity. Most authors used bioactive glass as a filler material. Out of a total of 244 citations, 15 articles were identified, where patients underwent mastoid obliteration with synthetic materials. The search focused on papers concerning the mastoid obliteration with synthetic material, as we focused on looking for outcomes and reported complications. We searched Web of Science, PubMed, and MEDLINE from 2008 to 2018 using the criteria mastoid obliteration, canal wall down mastoidectomy, chronic otitis media, and cholesteatoma. The purpose of this survey is to review the published literature related to the therapeutic value of mastoid obliteration with synthetic materials. The materials used for this reason are either biological or synthetic. The remaining large mastoid bowl is associated with a number of issues one of the main techniques that have been developed in order to avoid such problems is the obliteration of the mastoid cavity. Canal wall down mastoidectomy is a surgical technique used for the eradication of middle ear disease.
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