title: Revision surgery for canal wall down mastoidectomy: intra-operative findings and results.
abstract: CONCLUSIONS
  Canal wall down mastoid surgery following multiple earlier surgical failures can be revised by a well-trained experienced surgeon. A dry and safe ear is obtainable in most patients, and hearing preservation is also possible.
  
  
  OBJECTIVE
  To analyze the intra-operative findings in revision surgery for canal wall down (CWD) mastoidectomy and to ascertain the prognosis.
  
  
  METHODS
  A total of 76 revision mastoidectomies with tympanoplasties performed from March 2008 to May 2014 at the First Affiliated Hospital of Zhengzhou University in China were reviewed. The pre-operative, intra-operative, and post-operative data was recorded and analyzed.
  
  
  RESULTS
  The possible reason of previous surgical failures were confirmed by the operative findings, which included inadequate mastoidectomy or persistent air-cell disease (66/76 [86.8%]), recurrent or persistent cholesteatoma (44/76 [57.9%]), excessive opened cavity combined with complications (9/76 [11.8%]), and infected cavities (68/76 [89.5%]). In this study, disease control was achieved in 70 (92.1%) patients. Complications following previous surgery were modified by revision surgery. Hearing was significantly improved in the 54 cases with ossicular replacement prosthesis. After a mean follow-up of 22 months, the group of revision surgery with ossiculoplasty as a whole experienced a statistically significant hearing gain of 16.57 ± 11.96 dB (p < 0.05) at air conduction pure tone average (PTA).
authors.affiliation: a Department of Otology , the First Affiliated Hospital of Zhengzhou University , Zhengzhou , Henan , PR China.
authors.forename: Sujuan
authors.initials: S
authors.lastname: Li
authors.affiliation: a Department of Otology , the First Affiliated Hospital of Zhengzhou University , Zhengzhou , Henan , PR China.
authors.forename: Juan
authors.initials: J
authors.lastname: Meng
authors.affiliation: a Department of Otology , the First Affiliated Hospital of Zhengzhou University , Zhengzhou , Henan , PR China.
authors.forename: Fan
authors.initials: F
authors.lastname: Zhang
authors.affiliation: a Department of Otology , the First Affiliated Hospital of Zhengzhou University , Zhengzhou , Henan , PR China.
authors.forename: Xiaohua
authors.initials: X
authors.lastname: Li
authors.affiliation: a Department of Otology , the First Affiliated Hospital of Zhengzhou University , Zhengzhou , Henan , PR China.
authors.forename: Zhaobing
authors.initials: Z
authors.lastname: Qin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002681:China; D018424:Cholesteatoma, Middle Ear / Q000150:complications / Q000601:surgery; D005260:Female; D006309:Hearing; D006801:Humans; D008297:Male; D008416:Mastoid / Q000601:surgery*; D008875:Middle Aged; D019933:Ossicular Replacement; D010033:Otitis Media / Q000150:complications / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome; D014433:Tympanoplasty; D055815:Young Adult
keywords: Otitis media; mastoidectomy; surgical revision; tympanoplasty