TITLE:
Canal Wall down Mastoidectomy and Tympanoplasty in Cholesteatoma Surgery: Ten Years’ Experience
AUTHORS:
Salvatore Ferlito, Eugenia Allegra, Calogero Grillo, Gian Luca Fadda, Salvatore Conticello
KEYWORDS:
Tympanomastoid Surgery, Cholesteatoma, Tympanoplasty
JOURNAL NAME:
International Journal of Otolaryngology and Head & Neck Surgery,
Vol.5 No.5,
September
27,
2016
ABSTRACT: Tympanomastoid surgery for cholesteatoma is a procedure designed to eliminate the
disease and maintain a safe and dry ear. This retrospective study was designed to
evaluate the functional results of cholesteatoma patients who underwent canal wall
down mastoidectomy in conjunction with a tympanoplasty. Operated ears due to
chronic otitis media with cholesteatoma were considered for the study. The study
was carried out in 120 ears. The choice of technique for tympanoplasty is based on
the pathology encountered in the stapes superstructure. Patients were divided into
three: 1) Group A, a type II TPL with stapes columella reconstruction; 2) Group B, a
type III TPL with major columella reconstruction; and 3) Group C, a type IV TPL
using a temporalis fascia and thick cartilage to shield the round window. The operated
ears of Groups A and B, as compared to Group C, presented a significant decrease
in the pre-operative Air-bone gap and an increase in the number of operated
ears with an Air-bone gap between 0 - 20 dB. The study emphasizes the importance
of functional separation of the two acoustic windows by fascia and cartilage graft
when the stapes superstructure is missing but the footplate is mobile.