title: Efficacy of mastoid cortex plasty for middle ear aeration in intact canal wall tympanoplasty for cholesteatoma.
abstract: OBJECTIVE
  To determine the effect of closing the bone defect of the mastoid cortex using bone pate after mastoidectomy (mastoid cortex plasty) during the first-stage operation for the restoration of the mastoid cavity aeration.
  
  
  METHODS
  This was a prospective study.
  
  
  METHODS
  Tertiary medical center.
  
  
  METHODS
  Thirty-five patients with cholesteatoma invading the mastoid cavity.
  
  
  METHODS
  Seventeen patients received mastoid cortex plasty with scutum plasty and insertion of a Silastic sheet after removal of the cholesteatoma using a combined approach during the first-stage operation. The 18 control patients received only scutum plasty with the insertion of a Silastic sheet without mastoid cortex plasty during the first-stage operation.
  
  
  METHODS
  The restoration of the middle ear aeration was assessed with high-resolution computed tomography before both the first-stage operation and the second-stage operation.
  
  
  RESULTS
  The range of middle ear aeration ameliorated significantly whether or not mastoid cortex plasty was performed. Scutum plasty with the insertion of a Silastic sheet without mastoid cortex plasty was significantly effective only for the amelioration of the epitympanum aeration. Mastoid cortex plasty with scutum plasty with the insertion of a Silastic sheet was significantly effective for the amelioration of the epitympanum and also the mastoid cavity aeration. In both groups, before the first-stage operation, approximately 70% of the patients had good mesotympanum aeration, and the mesotympanum aeration ameliorated further after the first-stage operation, although this amelioration was not significant.
  
  
  CONCLUSIONS
  Mastoid cortex plasty is statistically effective for the amelioration of mastoid cavity aeration after the first-stage operation.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Kumamoto University School of Medicine, 1-1-1 Honjo, Kumamoto 860-8856, Japan.
authors.forename: Ryosei
authors.initials: R
authors.lastname: Minoda
authors.forename: Naoaki
authors.initials: N
authors.lastname: Yanagihara
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Hinohira
authors.forename: Eiji
authors.initials: E
authors.lastname: Yumoto
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D018424:Cholesteatoma, Middle Ear / Q000000981:diagnostic imaging / Q000601:surgery*; D020099:Coated Materials, Biocompatible; D004129:Dimethylpolysiloxanes; D004432:Ear, Middle / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008416:Mastoid / Q000601:surgery*; D008876:Middle Ear Ventilation; D019736:Prostheses and Implants; D012828:Silicones; D014057:Tomography, X-Ray Computed; D014433:Tympanoplasty
chemical_list: D020099:Coated Materials, Biocompatible; D004129:Dimethylpolysiloxanes; D012828:Silicones; C013830:baysilon