Efficacy of mastoid cortex plasty for middle ear aeration in intact canal wall tympanoplasty for cholesteatoma.
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.
Minoda
Ryosei
R
Department of Otolaryngology-Head and Neck Surgery, Kumamoto University School of Medicine, 1-1-1 Honjo, Kumamoto 860-8856, Japan.
Yanagihara
Naoaki
N
Hinohira
Yasuyuki
Y
Yumoto
Eiji
E
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
D020099:Coated Materials, Biocompatible; D004129:Dimethylpolysiloxanes; D012828:Silicones; C013830:baysilon