Title: A Comparative Study of Results of Canal Wall Up & Canal Wall down Mastoidectomy as a Surgical Treatment for Cholesteatoma

Authors: Dr Shikha Bhatt, Dr Vaibhav Kuchhal, Dr Shahzad Ahmad, Dr Varun Rawat, Dr Ravi Baniya

 DOI: https://dx.doi.org/10.18535/jmscr/v8i4.72

Abstract

   

Background: The aim of this study is to compare the results of canal wall up and canal wall down mastoidectomy as a surgical treatment for cholesteatoma.

Method: This study was a comparative prospective study carried out in the department of otorhinolaryngology.

Results & Conclusion: Hearing results in CWU mastoidectomy were better than in CWD mastoidectomy. With canal wall down technique, the rate of developing complications (persistent ear discharge) was significantly higher when compared with those in canal wall up technique. Other complications ie; perichondritis, wound dehiscence, facial nerve palsy were nil in either group. Recurrence or residual disease was not reported in our cases which may be due to short period of follow up (3 months).

Keywords: Chronic Ototis Media, Pure Tone Audiometry.

References

  1. Harold L & Tony W: Diseasesof the ear: a diseases ear, 6th edn; p 386.
  2. Telian AS, Schmalbach CE. Chronic otitis media. In:Snow Jr JB, Ballenger JJ, eds. Ballenger’s Otorhinolaryngology Head and Neck surgery, 16th Hamilton, Ontario: BC Decker,2003;PP:261
  3. Tos M, Lasu T. Hearinng after surgery for cholesteatoma using various techniques. Auris Nasus Larynx 1989;16(2):61-73
  4. Bhat PS, Gandhi G, A comparative study of hearing outcomes in canal wall up versus canal wall down mastoidectomy in our experience. Int J Otorhinolaryngol Head Neck Surg 2019;5:472-5.
  5. Kalita S, Uddin S, Patar M et al. A comparative study on the hearing outcome in canal wall down and intact canal wall mastoidectomy in chronic suppurative otitis media with special reference to atticoantral disease. International Journal of Research and Review. 2018; 5(6):94-103
  6. Osborn AJ, Papsin BC, James AL. Clinical indications for canal wall-down mastoidectomy in a pediatric population. Otolaryngology--Head and Neck Surgery. 2012 Aug 1;147(2):316-22.
  7. Varshney PK, Gupta R. Canal wall up versus canal wall down procedure: Comparative evaluation. Ind J Otol. 2009;15:20-2.
  8. Toner JG, Smyth GD. Surgical treatment of cholesteatoma: a comparison of three techniques. Am J Otol. 1990; 11(4): 247–9.
  9. Kos MI, Castrillon R, Montandon P, Guyot J-P. Anatomic and functional long-term results of canal wall-down mastoidectomy. Ann Otol Rhinol Laryngol. 2004; 113(11):872–6.
  10. GF and McElveen JT Jr: A randomised blinded study of canal wall up versus canal wall down mastoidectomy determining the differences in viewing middle ear anatomy and pathology. Am J Otol 1998, 19(5):574-578      
  11. Sadé J: Surgical planning of the treatment of cholesteatoma and post-operative follow-up. Ann Otol Rhinol Laryngol 2000; 109(4):372-6.
  12. Gantz BJ, Wilkinson EP, Hansen MR. Canal Wall Reconstruction Tympanomastoidectomy with Mastoid Obliteration. Laryngoscope. 2005; 115(10):1734-40.
  13. Mustafa SR. Comparison of Efficacy of Canal Wall Up Mastoidectomy with Canal Wall Down Mastoidectomy in Surgical Management of Otitis Media. JIMDC. 2017; 6(2):78-82.
  14. Ueda H, Nakashima T, Nakata S. Surgical Strategy for cholesteatoma  in children. Auris Nasus Larynx 2001 Apr : 28(2) : 125-9. 
  15. Harkness P, Brown PM, Fowler SM, Grant HR, Ryan RM, Topham JH. Mastoidectomy audit: results of the Royal College of Surgeons of England comparative audit of ENT surgery. Clin Otolaryngol. 1995;20:89–94.
  16. Rambo JH. Mastoid surgery: effect of retained mucosa on healing. Ann Otol Rhinol Laryngol. 1979;88:701–707.

Corresponding Author

Dr Vaibhav Kuchhal

Professor and Head of ENT Dept GMC Haldwani Uttarakhand