Tympanoplasty with mastoidectomy: canal wall up procedures.
Management of the mastoid in cases of chronic otitis media with cholesteatoma remains controversial. Whether to leave the canal wall up or perform a cavity technique continues to be debated. The author reviewed his personal cases of surgery for chronic otitis media over a 5-year period and studied 108 cases without prior surgery who required tympanoplasty with mastoidectomy for cholesteatoma. Thirty-two percent of the cases were in children 15 years of age and under. Over two thirds of the procedures were canal wall up, and the remainder of patients underwent a canal wall down technique with obliteration. There was little difference in the results between children and adults, with the exception of there being a tendency for a greater degree of ossicular destruction in the children and a greater incidence of residual disease at second stage surgery. There was a 3 percent incidence of recurrent cholesteatoma. It appears that the intact canal wall technique is preferable in both children and adults, when circumstances are favorable.
Brackmann
D E
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House Ear Clinic, Los Angeles, CA 90057.
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D002781:Cholesteatoma / Q000150:complications / Q000601:surgery*; D004429:Ear Ossicles / Q000601:surgery*; D004432:Ear, Middle / Q000503:physiopathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008416:Mastoid / Q000601:surgery*; D008875:Middle Aged; D009998:Ossicular Prosthesis; D010033:Otitis Media / Q000150:complications / Q000503:physiopathology*; D014432:Tympanic Membrane / Q000601:surgery*; D014433:Tympanoplasty