title: Intraoperative findings in revision canal wall down mastoidectomy.
abstract: Effective canal wall down mastoid surgery requires attention to certain key principles. We reviewed all cases requiring revision surgery at the Royal Victoria Eye and Ear Hospital over a 6 year period 1999-2004. Intraoperative findings which contributed to the need for revision surgery were identified. During this 6 year period 291 canal wall down mastoidectomies were performed. Thirty-seven were revision procedures. Nineteen (51%) cases were found to have recurrent or residual cholesteatoma. Sixteen (43%) cases had a high facial ridge, thirteen (35%) cases had an open middle ear. Nine (24%) cases had an inadequate meatus, 2 (5%) cases had a cavity sump. This study illustrated that a high facial ridge, an open middle ear segment, an inadequate meatoplasty and recurrent cholesteatoma were common intraoperative findings in this revision group. Eighty-nine percent of revision cases had dry, healed and safe cavities on follow up. Poor performance of the open technique is the most important factor in failure.
authors: Royal Victoria Eye and Ear Hospital, Adelaide Road, Dublin 2, Ireland eimearphelan@hotmail.com
authors: E
authors: E
authors: Phelan
authors: M
authors: M
authors: Harney
authors: H
authors: H
authors: Burns
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D018424:Cholesteatoma, Middle Ear / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008416:Mastoid / Q000601:surgery*; D008875:Middle Aged; D013506:Otologic Surgical Procedures / Q000379:methods / Q000706:statistics & numerical data; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome