Surgical management of troublesome mastoid cavities.
OBJECTIVE
To examine the reasons for discharging mastoid cavities, the operative findings during revision surgery, and the medium-term outcome.


METHODS
One hundred and forty revision mastoidectomies in 131 patients were studied. Post-operatively, patients were followed up at three, six and 12 months and then yearly.


METHODS
A variety of techniques were performed. Over 80 per cent of ears were treated with mastoid obliteration. Concomitant hearing restorative procedures were carried out in one-third of the ears.


RESULTS
The mastoid cavities were troublesome because of large cavity size, bony overhang, residual infected mastoid cells, the presence of cholesteatoma or perforations, and/or inadequate meatoplasty. One year after revision mastoidectomy, over 95 per cent of the ears had become completely 'dry' and water-resistant. Overall, 50.9 per cent of the ears had a 12-month post-operative air-bone gap of 20 dB or less.


CONCLUSIONS
Revision mastoidectomy has a high success rate in converting troublesome mastoid cavities into dry, water-resistant ears.
Department of Otolaryngology, The Ipswich Hospital NHS Trust, Ipswich, UK. matthewyung@btconnect.com
M
M
Yung
P
P
Tassone
I
I
Moumoulidis
S
S
Vivekanandan
D000293:Adolescent; D000328:Adult; D000368:Aged; D001844:Bone Conduction; D002648:Child; D018424:Cholesteatoma, Middle Ear / Q000453:epidemiology / Q000601:surgery*; D005500:Follow-Up Studies; D006314:Hearing Loss, Conductive / Q000601:surgery; D006801:Humans; D006882:Hydroxyapatites / Q000627:therapeutic use; D008416:Mastoid / Q000601:surgery*; D008875:Middle Aged; D010034:Otitis Media with Effusion / Q000453:epidemiology; D013506:Otologic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D011182:Postoperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology / Q000601:surgery; D012008:Recurrence; D012086:Reoperation; D013524:Surgical Flaps; D016896:Treatment Outcome; D014432:Tympanic Membrane / Q000473:pathology; D014433:Tympanoplasty; D055815:Young Adult
D006882:Hydroxyapatites