Comparison of obliteration materials used for revision canal wall-down mastoidectomy with mastoid obliteration.

AIM To describe our surgical technique and compare the results of obliteration materials. PATIENTS AND METHODS Fifty patients over a 7-year period were evaluated retrospectively. Out of these 50 consecutive patients, 29 had recurrent chronic otitis media (COM) with or without cholesteatoma and 21 patients had old open cavities. Efficacy of mastoid obliteration was assessed by an electronic chart review, otoendoscopic findings, temporal bone computerized tomography (CT) images, and postoperative caloric test. RESULTS Among 50 patients, inferiorly-based periosteal flap was used in 25 patients (50%) and anteriorly-based periosteal flap was used in the other 25 patients. Tympanic membrane and newly-formed external auditory canal wall was intact in 48 patients (96%). The newly-formed EAC provided sufficient aeration, and satisfactory aesthetic appearance. None of our patients complained of vertigo triggered by cold air or water. There was no significant difference in the caloric test results between the operated ear and the normal ear. No difference was observed in the caloric test between the bone pate and costal cartilage groups. CONCLUSION Our results indicate that mastoid obliteration using autogenous bone pate or costal cartilage is helpful in improving the outcomes of revision canal wall-down mastoidectomy in patients with an old radical cavity and recurrent COM or cholesteatoma.