Postoperative Results of Canal Wall Up Mastoidectomy Only Performing Anterior Tympanotomy

Byun, Jae Yong; Cha, Chang Il; Hong, Seok Min; Moon, Ji Ho; Lee, In Young; Hong, Nam Pyo

Abstract

BACKGROUND AND OBJECTIVES
Retrospective reflect of canal wall up (CWU) mastoidectomy with posterior tympanotomy revealed some problems such as ineffectiveness against the recurrence of cholesteatoma, reclosure of ventilation route and that a posterior tympanotomy might be harmful to inner ear. Objectives of this study is to evaluate the effect of mastoidectomy with anterior tympanotomy on postoperative hearing results and complications. SUBJECTS AND METHOD: From January 1998 through July 2001, 29 cases of CWU mastoidectomy with anterior tympanotomy were reviewed retrospectively. All of the cases were difficult to perform posterior tympanotomy due to anatomical variations and had lesions restricted to anterior epitympanum. The hearing results were assessed by postoperative 1-year pure tone average and postoperative 1-year air-bone gap (ABG), and we checked complications. RESULTS: Of the 29 cases, 21 cases (72.4%) had ABG <20 dB in the postoperative 1-year, with the postoperative 1-year ABG of 14.9+/-9.2 dB. The postoperative hearing gain was 10.1+/-10.6 dB. There were 3 cases of chorda tympani nerve cutting, 1 case of accidental malleoincudal joint dislocation and 1 case of recurrence. CONCLUSION: Anterior tympanotomy could be a good approach for ventilation in selected CWU mastoidectomy approach, and further long term follow-up is needed to study about recurrence.