Canal wall reconstruction and mastoid obliteration in canal wall down tympanomastoidectomized patients

Conclusion: Posterior canal reconstruction using autogenous bone pate and mastoid obliteration with allogenous cancellous bone chips (ACBCs) is a useful method to eliminate cavity problems after canal wall down tympanomastoidectomy (CWDT). It is also an appropriate method to obtain adequate middle ear space for hearing gain and to apply hearing aids for patients with poor eustachian tube function after surgery. Objective: This study was performed to suggest a new technique for posterior canal reconstruction and mastoid obliteration and to evaluate the outcome of the surgery. Patients and methods: The entire posterior canal was reconstructed with autogenous bone pate, and the new isolated mastoid cavity was obliterated with ACBCs in patients who had undergone CWDT and suffered from cavity problems. Outcomes were measured by external auditory canal shape, condition of the neotympanum, hearing outcome, improvement of cavity problems, and surgical complications. Results: In 90.9%, the reconstructed canal wall maintained a cylindrical shape. The drum healed without perforation/retraction in 90.9%. The average airbone gap value was 34.5 dB hearing level (HL) before the staged operation and 17.8 dB HL after the staged operation; 95.5% had no more cavity problems. Minor postauricular wound infection was the most common complication (13.6%).