Canal wall reconstruction tympanomastoidectomy with mastoid obliteration.
OBJECTIVE
This study was designed to evaluate the authors' experience with canal wall reconstruction (CWR) tympanomastoidectomy with mastoid obliteration in the treatment of chronic otitis media with cholesteatoma.


METHODS
Institutional review board approved retrospective case review.


METHODS
Retrospective review was performed of all patients undergoing CWR tympanomastoidectomy with mastoid obliteration from 1997 to 2004. Data included pre- and postoperative audiometry, findings at second look surgery with ossiculoplasty, and postoperative complications including wound infection and canal wall displacement.


RESULTS
One hundred thirty ears in 127 adults and children underwent the procedure. Mean time postoperative was 48 (range 2-94) months. A second look ossiculoplasty was performed in 102 (78%). Percentage of ears that remain safe without evidence of recurrence was 98.5. The postoperative infection rate decreased from an initial rate of 14.3% to 4.5% for the last 88 ears after protocol modification. Recurrence occurred in two (1.5%) patients, requiring conversion to a canal wall down mastoidectomy.


CONCLUSIONS
A CWR technique can provide improved intraoperative exposure of the middle ear and mastoid without creating a mastoid bowl and reduces the incidence of recurrent disease. A single procedure is used for all patients with acquired cholesteatoma, including children.
Gantz
Bruce J
BJ
Department of Otolaryngology--Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, 52242, USA. bruce-gantz@uiowa.edu
Wilkinson
Eric P
EP
Hansen
Marlan R
MR
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D018424:Cholesteatoma, Middle Ear / Q000150:complications / Q000601:surgery*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008416:Mastoid / Q000601:surgery; D008875:Middle Aged; D010033:Otitis Media / Q000150:complications / Q000601:surgery*; D013506:Otologic Surgical Procedures / Q000379:methods*; D012189:Retrospective Studies; D012665:Semicircular Canals / Q000601:surgery; D016896:Treatment Outcome; D014432:Tympanic Membrane / Q000601:surgery