title: Results, hearing rehabilitation, and follow-up with magnetic resonance imaging after tympanomastoid exenteration, obliteration, and external canal overclosure for severe chronic otitis media.
abstract: OBJECTIVE
  We sought to evaluate the results, auditory rehabilitation, and follow-up with magnetic resonance imaging (MRI) after tympanomastoid exenteration with obliteration of the mastoid cavity and overclosure of the external ear canal in patients with severe chronic otitis media that was resistant to medical therapy and conventional surgery and was associated with a profound sensorineural or severe conductive hearing loss.
  
  
  METHODS
  Twenty-nine patients were analyzed and underwent this surgical technique. Twelve patients had, during the same or later stage, either cochlear implantation, fixture implantation for a bone-anchored hearing aid, or middle ear implantation. For follow-up control of the obliterated cavity, delayed gadolinium-enhanced, T1-weighted MRI in combination with non-echo planar imaging diffusion weighted sequences were used.
  
  
  RESULTS
  No patient had recurrent otorrhea after an average follow-up period of 4.75 years. One patient had a residual cholesteatoma as shown by new MRI techniques, and this was successfully resected. One patient developed complications 6 months after 1-stage tympanomastoid exenteration and cochlear implantation.
  
  
  CONCLUSIONS
  This technique is very useful in selected patients with severe chronic otitis media that is resistant to medical therapy and surgery and is associated with a profound sensorineural or severe conductive hearing loss. New sequences in MRI are used for postoperative follow-up of these obliterated cavities and seem reliable for the detection of residual or recurrent cholesteatoma. Middle ear implantation and cochlear implantation can be relatively safely performed in these patients in a second stage.
authors.affiliation: University Department of Otorhinolaryngology, AZ Sint-Augustinus Hospital, Wilrijk (Antwerp), Belgium.
authors.forename: Katrien
authors.initials: K
authors.lastname: Ketelslagers
authors.forename: Thomas
authors.initials: T
authors.lastname: Somers
authors.forename: Bert
authors.initials: B
authors.lastname: De Foer
authors.forename: Andrzej
authors.initials: A
authors.lastname: Zarowski
authors.forename: Erwin
authors.initials: E
authors.lastname: Offeciers
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004424:Ear Canal / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006309:Hearing / Q000502:physiology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010033:Otitis Media / Q000175:diagnosis / Q000534:rehabilitation* / Q000601:surgery; D013506:Otologic Surgical Procedures / Q000379:methods*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome