Langzeitergebnisse nach Radikalhöhlenverkleinerung mit Knochenmehl und Knorpelabdeckung

Long-Term Results following Mastoid Obliteration in Canal Wall Down Tympanomastoidectomy Background: The primary goal in chronic otitis media is the creation of a dry, safe ear with hearing preservation and reconstruction. This study was designed to evaluate the authors' experience using autologous bone pate and conchal cartilage for mastoid obliteration in canal wall down tympanomastoidectomy. Methods: A retrospective long-term review in 2003 of thirtynine ears was performed, which underwent mastoid obliteration in canal wall down tympanomastoidectomy between 1993 and 2002 performed by the senior author. Data included questionnaire results, clinical observation as well as pre-and postoperative audiometry. Results: Long-term follow-up shows, that 38 out of 39 ears maintained a small, dry, healthy mastoid cavity. Recurrent cholesteatoma occurred in a single patient. A self-cleaning mastoid bowl was achieved in 90%, resulting in reduced follow-up visits. Postoperative vertigo in canal wall down revision surgery is clearly diminished due to the mastoid obliteration. Overall, 92% of patients are satisfied with the surgical result. Conclusion: Obliteration of a canal wall down mastoid cavity by autologous bone pate and conchal cartilage is a reliable and effective technique that results in a dry, trouble free mastoid cavity in 90% of the patients with chronic otitis media.