title: Tympanomastoidectomy: Comparison between canal wall-down and canal wall-up techniques in surgery for chronic otitis media.
abstract: BACKGROUND
  Chronic otitis media (COM) is an inflammatory condition associated with otorrhea as well as large and persistent perforations of the tympanic membrane in some cases. COM can also lead to cholesteatoma. Surgical treatment with canal wall-down and canal wall-up tympanomastoidectomy is considered for both types of illness. The choice of technique is controversial and is dependent on several factors, including the extent of disease.
  
  
  OBJECTIVE
  We aimed to evaluate surgical outcomes in COM patients with and without cholesteatoma treated with canal wall-down and canal wall-up tympanomastoidectomy. Disease eradication and post-operative auditory thresholds were assessed.
  
  
  METHODS
  Patient records from the otorhinolaryngology department of a tertiary hospital were assessed retrospectively.
  
  
  RESULTS
  Patients who underwent canal wall-up tympanomastoidectomy had a higher rate of revision surgery, especially those with cholesteatoma. However, there were no statistically significant differences in post-operative hearing thresholds between the two techniques.
  
  
  CONCLUSIONS
  The canal wall-down technique is superior to the canal wall-up technique, especially for patients with cholesteatoma.
authors.affiliation: MD in Infectology at the Federal University of Minas Gerais. Assistant Doctor - Otolaryngology Clinic of Santa Casa B.H.
authors.forename: Alexandre Fernandes de
authors.initials: AF
authors.lastname: Azevedo
authors.affiliation: Resident of Plastic Surgery at the Hospital Mater Dei.
authors.forename: Anna Bárbara de Castro
authors.initials: AB
authors.lastname: Soares
authors.affiliation: Resident of Otolaryingology at the Santa Casa B.H.
authors.forename: Henrique Queiroz Correa
authors.initials: HQ
authors.lastname: Garchet
authors.affiliation: M.D. in Otolaryngology at the Federal University of São Paulo. Honorary Chief of the Otolaryngology Clinic of Santa Casa B.H.
authors.forename: Nicodemos José Alves de
authors.initials: NJ
authors.lastname: Sousa
keywords: Cholesteatoma; Chronic Disease; Hearing Loss; Middle Ear; Otitis Media; Reoperation