Obliteration of mastoid cavity and reconstruction of attic area using conchal cartilage

Aim: Aim of this study was to describe an effective technique for mastoid cavity obliteration and reconstruction attic region in canal wall down Tympano mastoidectomy for unsafe chronic otitis media and to review its efficacy in producing a dry, low maintenance, small mastoid cavity. Material and method: In this prospective study, 100 patients were selected who were undergoing procedures for active and inactive chronic otitis with cholesteotoma. All surgical interventions involving mastoid cavity obliteration or reconstruction of attic area and restoration of middle ear space by use of conchal cartilage with reconstruction of tympanic membrane and also ossicular reconstruction was achieved with either a partial or total ossicular replacement prosthesis. The preoperative inclusion criteria were a cholesteatoma with attic destruction, a sclerotic mastoid with poor Eustachian tube function and an intact posterior canal wall. Other middle ear diseases such as chronic otitis media without cholesteatoma were included, but the latter two criteria were applied equally. Results: A completely dry cavity was achieved 80 to 85% of hundred patients (80 to 85 % confidence interval) had an overall significant improvement of in hearing and their P value was >1% to 2%and there were no residual or recurrent cholesteatoma. The peak age incidence in this study was out of 100, the highest was seen among 20-30 years’ age group i.e. 40 out of 100. And among 40, 26 were males and 14 were females. The least age incidence in this study was 2 which were seen in age of above 60 years. The conchael cartilage was used the highest in cholesteatoma i.e. 66 of 100 of which 40 were males and 26 were females. The % rate of graft failure was highest in Rev. CWD method i.e. 37.5%. The least % rate of graft failure was 10 % in ICW method. Conclusion: Conchal cartilage is the best material for reconstruction obliteration of cavity proved to be a useful adjustment in the surgical management of the chronically draining cavity.