Hostname: page-component-848d4c4894-v5vhk Total loading time: 0 Render date: 2024-06-21T16:51:26.914Z Has data issue: false hasContentIssue false
  • English
  • Français

Canal wall down mastoidectomy: causes of failure, pitfalls and their management

Published online by Cambridge University Press:  29 June 2007

Sanjaya Bhatia ,
Sandeep Karmarkar ,
Giuseppe DeDonato ,
Cemil Mutlu ,
Abdelkader Taibah ,
Alessandra Russo  and
Mario Sanna
Sanjaya Bhatia*
Affiliation:
Clinical Research Fellows, Piacenza, Italy.
Sandeep Karmarkar
Affiliation:
Clinical Research Fellows, Piacenza, Italy.
Giuseppe DeDonato
Affiliation:
Clinical Research Fellows, Piacenza, Italy.
Cemil Mutlu
Affiliation:
Clinical Research Fellows, Piacenza, Italy.
Abdelkader Taibah
Affiliation:
Gruppo Otologico, Piacenza, Italy.
Alessandra Russo
Affiliation:
Gruppo Otologico, Piacenza, Italy.
Mario Sanna
Affiliation:
Gruppo Otologico, Piacenza, Italy.
*
Dr Mario Sanna, Gruppo Otologico, Via Emmanueli, 42, 29100 Piacenza, Italy. Fax: 39 523 453708
Get access Rights & Permissions [Opens in a new window]

Abstract

Managing patients with failed canal wall down mastoidectomy, requires a meticulous approach to control the disease and restore hearing. The present article reviews the causes of failure of the primary procedure and pitfalls encountered in 105 patients referred to our centre for revision canal wall down mastoidectomy. At post-revision surgery there were no cases with residual or recurrent cholesteatoma. The failures in our revision procedure were due to tympanic membrane perforation which occurred in five percent (n = 4) and intermittent otorrhoea in two percent (n = 2). A dry cavity with adequate middle ear space allowed for optimum audiological function even in revision canal wall down procedures.

Keywords

CholesteatomaMastoid, surgery, revision
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 109 , Issue 7 , July 1995 , pp. 583 - 589
Copyright
Copyright © JLO (1984) Limited 1995

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aristegui, M., Falcioni, M., Saleh, E., Taibah, A. K., Russo, A., Landolfi, M., Sanna, M., (1994). Meningoencephalic herniation into the middle ear: a report of 27 cases. Laryngoscope (in press).Google Scholar
Brackmann, D. E. (1992) Mastoid cavity management. Operative Techniques in Otolaryngology-Head and Neck Surgery 3: 8–14.CrossRefGoogle Scholar
Feenstra, L., Sanna, M., Zini, C, Gamoletti, R., Delogu, P. (1985) Surgical treatment of brain herniation into the middle ear and mastoid. American Journal of Otology 6: 311–315.Google ScholarPubMed
Fisch, U. (1994) Mastoidectomy. In Tympanoplasty, Mastoidectomy and Stapes Surgery. Georg Thieme, Stuttgart/New York, pp 145–199.Google Scholar
Glasscock, M. E. III., Poe, D. S., Johnson, G. D., Ragheb, S. (1989) Surgical management of the previously operated chronic ear. In Cholesteatoma and Mastoid Surgery. (Tos, M., Thomsen, J., Peitersen, E., eds.). Kugler and Ghedini, Amsterdam/Berkeley/Milano, pp 1027–1032.Google Scholar
Goldenberg, R. A. (1988) Sink-trap effect as a cause of failure in mastoidectomy. Laryngoscope 98: 1143–1144.CrossRefGoogle ScholarPubMed
Gulya, A. J., Schweitzer, L. (1992) Revision mastoid surgery. Operative Techniques in Otolaryngology—Head and Neck Surgery 3: 39–42.CrossRefGoogle Scholar
Jackson, C. G., Glasscock, M. E. III, Nissen, A. J., Schwaber, M. K., Bojrab, D. I. (1985) Open mastoid procedures: contemporary indications and surgical technique. Laryngoscope 95: 1037–1043.CrossRefGoogle ScholarPubMed
Karmarkar, S., Bhatia, S., DeDonato, G., Saleh, E., Taibah, A., Russo, A., Sanna, M. (1994) Cholesteatoma surgery: the individualized technique. Annals of Otology, Rhinology and Laryngology (in press).Google Scholar
Kinney, S. E. (1977) The problem mastoid cavity: medical and surgical management. Laryngoscope 87: 1853–1860.CrossRefGoogle ScholarPubMed
Kveton, J. F. (1992) The facial nerve in revision mastoid surgery: avoiding complications. Operative Techniques in Otolaryngology–Head and Neck Surgery 3: 66–72.CrossRefGoogle Scholar
Kveton, J. F. (1992) Meatoplasty. Operative Techniques in Otolaryngology-Head and Neck Surgery 3: 276–278.CrossRefGoogle Scholar
Nadol, J. B. Jr (1985) Causes of failure of mastoidectomy for chronic otitis media. Laryngoscope 95: 410–413.CrossRefGoogle ScholarPubMed
Paparella, M. M., Kim, C. H. (1977) Mastoidectomy update. Laryngoscope 87: 1977–1988.CrossRefGoogle ScholarPubMed
Pillsbury, H. C. III, Carrasco, V. N. (1990) Revision mastoidectomy. Archives of Otolaryngology, Head and Neck Surgery 116: 1019–1022.CrossRefGoogle ScholarPubMed
Sadé, J. (1987) Treatment of cholesteatoma. American Journal of Otology 8: 524–533.Google ScholarPubMed
Sadé, J., Weinberg, J., Berco, E., Brown, M., Halevy, A. (1982) The marsupialized (radical) mastoid. In Cholesteatoma and Mastoid Surgery. (Sadé, J. ed.), Kugler, Amsterdam, pp. 537–542.Google Scholar
Sanna, M. (1983) Results in microsurgery of cholesteatoma. In Microsurgery of Cholesteatoma of the Middle Ear. (Zini, C, Sheehy, J. L., Sanna, M. eds.), Libreria Scientifica gia Ghedini, Milano, pp 173–180.Google Scholar
Sanna, M., Zini, C., Gamoletti, R., Taibah, A. K., Russo, A., Scandellari, R. (1988) Closed versus open technique in the management of labyrinthine fistulae. American Journal of Otology 9: 470–475.Google ScholarPubMed
Sanna, M., Zini, C., Gamoletti, R., Frau, N., Taibah, A. K., Russo, A., Pasanisi, E. (1993a) Petrous bone cholesteatoma. Skull Base Surgery 3: 201–213.CrossRefGoogle ScholarPubMed
Sanna, M., Zini, G., Bacciu, S., Scandellari, R., Russo, A., Shaan, M., Taibah, A., Szymanski, M. (1993b) Management of labyrinthine fistula. In Cholesteatoma and Mastoid Surgery. (Nakano, Y. ed), Kugler, Amsterdam/New York, pp 557–558.Google Scholar
Sheehy, J. L. (1985) Obliterative procedures in cholesteatoma surgery. American Journal of Otology 6: 9–12.Google ScholarPubMed
Sheehy, J. L. (1988) Cholesteatoma surgery: canal wall down procedures. Annals of Otology, Rhinology and Laryngology 97: 30–35.CrossRefGoogle ScholarPubMed
Sismanis, A., Hutchinson, L., Abedi, E. (1989) Chronic otitis media: surgical failures and management. American Journal of Otology 10: 460–465.Google ScholarPubMed
Smyth, G. D. L. (1985a) Cholesteatoma surgery: the influence of the canal wall. Laryngoscope 95: 92–96.CrossRefGoogle ScholarPubMed
Smyth, G. D. L. (1985b) Canal wall for cholesteatoma: up or down? Long-term results. American Journal of Otology 6: 1–2.Google ScholarPubMed