title: Alternative to canal wall-down mastoidectomy for sclerotic mastoid cavities: epitympanoplasty with mastoid obliteration.
abstract: OBJECTIVE
  Surgical procedures for chronic ear disease can be grossly divided into two tympanoplasty procedures: canal wall-up and canal wall-down (CWD) mastoidectomies. The choice depends on the surgeon's preference. Epitympanoplasty with mastoid obliteration (EMO) has shown postoperative results similar to those of CWD mastoidectomy with long-term follow-up. In this study, we compared the outcomes of EMO and CWD mastoidectomy in preoperatively sclerotic mastoid cavities with cholesteatoma, chronic otitis media with poor eustachian tube function, or adhesive otitis media. The operations were performed by the same surgeons in order to eliminate any effect of surgeon preference on the surgical outcomes.
  
  
  METHODS
  We reviewed the medical records of patients who underwent tympanoplasty with EMO (EMO group) or CWD mastoidectomy (CWD group) and followed them for more than 28 months. The postoperative outcomes were analyzed and compared.
  
  
  RESULTS
  The EMO and CWD groups comprised 132 and 110 ears, respectively. In both groups, the air-bone gaps were significantly reduced after operation. The relapse rates of the groups were similar. Cavity problems were the most common complication in the CWD group. The overall complication rate in the EMO group was significantly lower than that in the CWD group (p = 0.044).
  
  
  CONCLUSIONS
  Epitympanoplasty with mastoid obliteration can be considered an alternative procedure to CWD mastoidectomy in patients with preoperatively sclerotic mastoid cavities. It gives similar surgical results and has fewer complications.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Inje University College of Medicine, Busan Paik Hospital (Heo), Busan, Republic of Korea.
authors.forename: Kyung Wook
authors.initials: KW
authors.lastname: Heo
authors.forename: Myung Koo
authors.initials: MK
authors.lastname: Kang
authors.forename: Jae Yeong
authors.initials: JY
authors.lastname: Park
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D018424:Cholesteatoma, Middle Ear / Q000473:pathology / Q000601:surgery*; D004424:Ear Canal / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008416:Mastoid / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D013506:Otologic Surgical Procedures / Q000379:methods; D012189:Retrospective Studies; D012598:Sclerosis; D016896:Treatment Outcome; D014433:Tympanoplasty / Q000379:methods*
keywords: ear disease; mastoid cavity; surgery