[The short-term efficacy of autogenous bone pate and palva graft for obliterating huge mastoid cavity in canal wall-down approach].
OBJECTIVE
To observe the short-term efficacy of autogenous bone pate and Palva graft for obliterating huge remnant mastoid cavity in canal wall down approach.


METHODS
Retrospective analysis clinical data of twenty-one cholesteatomatous cases operated by one surgeon from 2004 to 2007. In twelve cases, simultaneous III type tympanoplasty (Sheehy, P. O. P) was performed. Other 9 cases had undergone mastoidectomy elsewhere before the admission. Six of them were still draining with huge remnant mastoid cavity, and the rest three patients had relapsed cholesteatomas with intermittent draining and huge mastoid cavity. Normal saline solution perfusion was used to measure the volume of remnant mastoid cavity. The criterion of huge remnant mastoid cavity is more than 8 ml.


RESULTS
Of twelve primary cases with III type tympanoplasty, 11 patients maintained a small, dry, and healthy mastoid cavity after twenty-seven days. The average increase of hearing level of them was 17.5dB, and the air-bone gap is less than 20 dB. Of one patient, bone pate was infected and was discharged. A dry mastoid cavity was achieved until fifty-five days after surgery. The patient is keeping a big air-bone gap caused by displacement of ossicle chain prosthesis. Just eighteen days later, other nine cases of revision mastoidectomy achieved a small, dry, and healthy mastoid cavity, with lightly improved hearing level.


CONCLUSIONS
Obliteration of a canal wall down huge mastoid cavity by Palva graft with autologous bone pate is a reliable and effective technique that results in a small, dry, low-maintenance mastoid cavity. The short-term efficacy of simultaneous III tympanoplasty is satisfactory if patient selection is suitable.
Zhou
Yongqing
Y
Department of Otolaryngology-Head and Neck Surgery, Bethune International Peace Hospital, Shijia-zhuang 050082, China. likevan2000@yahoo.com.cn
Li
Xiaoming
X
Qu
Yongtao
Y
Shen
Yupeng
Y
Shao
Yongliang
Y
Shang
Jianhua
J
Wang
Yingli
Y
D000293:Adolescent; D000328:Adult; D002781:Cholesteatoma / Q000601:surgery*; D018424:Cholesteatoma, Middle Ear / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008416:Mastoid / Q000601:surgery*; D008875:Middle Aged; D012189:Retrospective Studies; D013524:Surgical Flaps; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014433:Tympanoplasty / Q000379:methods; D055815:Young Adult