A comparative analysis of canal wall reconstruction mastoidectomy over canal wall down mastoidectomy

Abstract

Aim: This study aims to investigate the advantages of canal wall reconstruction mastoidectomy (C.W.R.) over the canal wall down (CWD) mastoidectomy. Material and method: A prospective study was conducted on sixty patients with cholesteatoma who underwent operation from September 2010 to October 2016. Patients were divided into two groups: “Group A," posterior canal wall reconstruction group (C.W.R.) with 28 patients (28 ears) and “Group B” which included 32 patients (32 ears) in whom canal wall down mastoidectomy (CWD) was done without reconstruction. The patients were followed up at 3 months and 6 months postoperatively with otoendoscopy to look for recurrence or residual disease, the occurrence of any complications, and for hearing assessment. Results: Group A (C.W.R.) patients were cosmetically better, and none had postoperative cavity problems. While in Group B (CWD), 16 patients (50%) had a cavity problem. Group A CWR group also had early epithelization. Both methods had hearing improvement postoperatively. Group A had more hearing improvement than Group B. Conclusion: The C.W.R. method is a safe method for eliminating the problem of the mastoid cavity. This surgery can be easily taught and applied universally in all cholesteatoma patients as a primary treatment. The C.W.R. technique provides improved exposure to the middle ear without creating a mastoid bowl, which significantly reduces the incidence of residual and recurrent disease. These results indicate that the C.W.R. method is better than the CWD operation.