Mark found 1.6% involvement for Eustachian tube in his revision surgeries.11 According to his study cleaning of the Eustachian tube involvement is possible in one stage, though tympanic sinus and facial recess require canal wall down mastoidectomy. Since cholesteatoma extension is widespread in most of our patients, conducting limited surgical approaches requires precise selections of patients.
Ten-year results of canal wall down mastoidectomy for acquired cholesteatoma.
All the patients in our study underwent canal wall down mastoidectomy. Some authors prefer canal wall up mastoidectomy as hearing threshold are worse after canal wall down mastoidectomy.
Canal wall down mastoidectomy is very safe procedure when properly performed.
Performance of DWI in the identification of cholesteatoma in patients following a canal wall down mastoidectomy
Sensitivity 93% Specificity 60% Positive predictive value 87% Negative predictive value 75% Accuracy 80% DWI: diffusion-weighted imaging
Out of 20 patients who had undergone tympanoplasty with cortical mastoid bone after canal wall down mastoidectomy, the mean pre-operative air-bone gap was 39.04[+ or -]8.06dB and post-operative mean air-bone gap was 22.47[+ or -]10.07, suggesting significant improvement of hearing gain (p=<0.001).
Canal wall down mastoidectomy has better disease clearance than canal wall up mastoidectomy surgery.
Revision canal wall down mastoidectomy
with canaloplasty was performed.
Canal wall down mastoidectomy
was done in all these patients and the cavity was dressed with wet collagen.
For many years, Canal wall down Mastoidectomy
(CWDM) was considered to be the gold standard for the management of cholesteatoma.
This operation can be combined with either an intact canal wall or a canal wall down mastoidectomy
to eradicate disease from the mastoid.
This condition is surgically treated by a canal wall down mastoidectomy
with tympanoplasty wherein disease is eradicated from the middle ear and mastoid with reconstruction of the hearing mechanism.