ISSN: 1300 - 6525 E-ISSN: 2149 - 0880
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ORIGINAL RESEARCH

Comparison of the Recovery Results of Patients Who Underwent Canal Wall-Down Mastoidectomy with or Without Obliteration
Açık Kavite Mastoidektomi Yapılan Hastalarda Obliterasyon Yapılanlar ile Yapılmayanlar Arasında İyileşme Sonuçlarının Karşılaştırılması
Received Date : 01 Feb 2019
Accepted Date : 18 Mar 2019
Doi: 10.24179/kbbbbc.2019-65130 - Makale Dili: TR
KBB ve BBC Dergisi 2019;27(1):14-21
Copyright © 2020 by Turkey Association of Society of Ear Nose Throat and Head Neck Surgery. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Objective: To compare the results of canal wall-down mastoidectomy with or without obliteration. Material and Methods: Patients who underwent canal wall-down mastoidectomy were divided into two groups. Obliteration with cartilage graft and temporal fasica was made in the first group and not made in the second. The study started with 65 patients but was terminated with 54 patients because of patients’ non-attendance. There were 24 and 30 patients in obliteration and non-obliteration groups respectively. Preoperative hearing thresholds were recorded and postoperative tests were made 1 and 6 months after the operation. Also examination findings and cavity volumes were recorded and compared. p value <0.05 was considered statistically significant. Results: The average value of pure tone hearing thresholds and air-bone gaps in the 6th month were 51.8 and 26.1 dB in the first group and 50.4 and 24.6 dB in the second. Time of getting dry ear was 5.2 weeks in the first group and 5 weeks in the second. Completion time of epitelization was 6.45 weeks in the first group and 6.33 weeks in the second. Value of cavity volume was 1.91 and 1.65 mL in the first and sixth month in the first group and 1.93 and 1.66 mL in the second. No significant scanning difference was found. Conclusion: No significant difference was found when compared two groups for the postoperative hearing thresholds, time of getting dry ear and completion of epitelisation and cavity volumes.
ÖZET
Amaç: Açık teknik mastoidektomi yapılan hastalarda, kavite obliterasyonu yapılanlarla yapılmayanların iyileşme sonuçlarının karşılaştırılmasıdır. Gereç ve Yöntemler: Kolesteatomlu kronik otitis media nedeni ile açık kavite mastoidektomi yapılan hastalar iki gruba ayrıldı. Birinci gruba kıkırdak ve temporal fasiya ile kavite obliterasyonu yapılır iken, ikinci gruba obliterasyon yapılmadı. Çalışmaya 65 hasta alındı. Ancak takibe gelmeyenler nedeniyle çalışma 54 hasta ile tamamlandı. Obliterasyon yapılan grupta 24, diğer grupta 30 hasta bulunmakta idi. Ameliyat öncesi işitme eşikleri kaydedilen hastaların ameliyat sonrası testleri bir ve altıncı ayda yapıldı. Muayene bulguları kaydedildi. Kavite hacimleri ölçüldü ve karşılaştırıldı. İstatistiki anlamlılık için p<0,05 kabul edildi. Bulgular: Birinci grupta ortalama saf ses işitme eşiği ve hava-kemik açıklığı (HKA) değeri postoperatif altıncı ayda sırasıyla 51,8 ve 26,1 dB bulunur iken, ikinci grupta 50,4 ve 24,6 dB bulundu. Birinci grupta ortalama 5,2, ikinci grupta beş haftada kuru kulak elde edilirken; birinci grupta 6,45, ikinci grupta ise 6,33 haftada epitelizasyon tamamlandı. Birinci grupta birinci ayda kavite hacmi 1,91 ve altıncı ayda 1,65 mL bulunur iken, ikinci grupta 1,93 ve 1,66 ml bulundu. Sonuç: İki grup arasında postoperatif işitme eşikleri, kuru kulak elde etme ve epitelizasyonun tamamlanma süreleri, kavite hacimleri açısından istatistiki olarak anlamlı fark bulunmamıştır.
KAYNAKLAR
  1. Kimitsuki T, Suda Y, Kawano H, Tono T, Komune S. Correlation between MRI findings and second-look operation in cholesteatoma surgery. ORL J Otorhinolaryngol Relat Spec. 2001;63(5):291-3. [Crossref]  [PubMed] 
  2. Dornhoffer JL, Smith J, Richter G, Boeckmann J. Impact on quality of life after mastoid obliteration. Laryngoscope. 2008;118(8):1427-32. [Crossref]  [PubMed] 
  3. Estrem SA, Highfill G. Hydroxyapatite canal wall reconstruction/mastoid obliteration. Otolaryngol Head Neck Surg. 1999;120(3):345-9. [Crossref] 
  4. Ramsey MJ, Merchant SN, McKenna MJ. Postauricular periosteal-pericranial flap for mastoid obliteration and canal wall down tympanomastoidectomy. Otol Neurotol. 2004;25 (6):873-8. [Crossref]  [PubMed] 
  5. Cho SW, Cho YB, Cho HH. Mastoid obliteration with silicone blocks after canal wall down mastoidectomy. Clin Exp Otorhinolaryngol. 2012;5(1):23-7. [Crossref]  [PubMed]  [PMC] 
  6. Maniu A, Cosgarea M. Mastoid obliteration with concha cartilage graft and temporal muscle fascia. ORL J Otorhinolaryngol Relat Spec. 2012;74(3):141-5. [Crossref]  [PubMed] 
  7. Ojala K, Sorri M, Sipila P, Palva A. Late changes in ear canal volumes after mastoid obliteration. Arch Otolaryngol. 1982;108(4): 208-9. [Crossref]  [PubMed] 
  8. Kim BG, Kim HJ, Lee SJ, Lee E, Lee SA, Lee JD.Outcomes ofmodified canal wall downmastoidectomy and mastoid obliteration using autologous materials. Clin Exp Otorhinolaryngol. 2019 Feb 1. Doi: 10.21053/ceo.2018.01333. [Epub ahead of print]. [Crossref] 
  9. Kuo CL, Liao WH, Shiao AS. A review of current progress in acquired cholesteatoma management. Eur Arch Otorhinolaryngol. 2015; 272(12):3601-9. [Crossref]  [PubMed] 
  10. Osborn AJ, Papsin BC, James AL. Clinical indications for canal wall-down mastoidectomy in a pediatric population. Otolaryngol Head Neck Surg. 2012;147(2):316-22. [Crossref]  [PubMed] 
  11. Kuo CL, Shiao AS, Liao WH, Ho CY, Lien CF. How long is long enough to follow up children after cholesteatoma surgery? A 29-year study. Laryngoscope. 2012;122(11):2568-73. [Crossref]  [PubMed] 
  12. Plester D, Steinbach E. Histologic fate of tympanic membrane and ossicle homografts. Otolaryngol Clin North Am. 1977;10(3):487- 99.
  13. Chhapola S, Matta I. Mastoid obliteration versus open cavity: a comparative study. Indian J Otolaryngol Head Neck Surg. 2014;66(Suppl 1):207-13. [Crossref] 
  14. Deshmukh S, Sharma A, Dabholkar J. Mastoid cavity obliteration: our experience. Otolaryngol Pol. 2012;66(6):379-81. [Crossref]  [PubMed] 
  15. Wadhwa V, Anand TS, Kumar S, Kathuria G, Rana I. Periosteo-temporofascial flap for cavity obliteration-first Indian study. Indian J Otolaryngol Head Neck Surg. 2003;55(3):170-4.
  16. BrowningG,Gatehouse S. Acoustical characteristics of surgically altered human temporal bones. Clin Otolaryngol Allied Sci. 1984;9(2):87-91. [Crossref] 
  17. Evans RA, Day GA, Browning GG. Open-cavity mastoid surgery: its effect on the acoustics of the external ear canal. Clin Otolaryngol Allied Sci. 1989;14(4):317-21. [Crossref]  [PubMed] 
  18. Jang CH. Changes in external ear resonance after mastoidectomy: open cavity mastoid versus obliterated mastoid cavity. Clin Otolaryngol Allied Sci. 2002;27(6):509-11. [Crossref]  [PubMed] 
  19. Tolley NS, Ison K, Mirza A. Experimental studies on the acoustic properties of mastoid cavities. J Laryngol Otol. 1992;106(07):597-9. [Crossref]  [PubMed] 
  20. Gacek RR. Mastoid and middle ear cavity obliteration for control of otitis media. Ann Otol Rhinol Laryngol. 1976;85(3 Pt 1):305-9. [Crossref]