Retrograde mastoidectomy with canal wall reconstruction with bone graft in acquired cholesteatoma

Abstract

Background: This study aimed to report the surgical outcomes of retrograde mastoidectomy with canal wall reconstruction using a bone graft that secured in place using glass ionomer cement (GIC) in adult patients with acquired cholesteatoma. Results: This study was conducted on 50 adult patients with acquired cholesteatoma who underwent retrograde mastoidectomy with a reconstruction of canal wall using a bone graft from the mastoid cortex. The preoperative and postoperative audiological evaluation was done; in addition, non-echoplanar (EPI) diffusion-weighted MRI was obtained at least 1 year postoperatively to detect recidivism of cholesteatoma. Recidivism of cholesteatoma was observed in 4/50 ears (8%) using diffusion-weighted MRI and confirmed during revision mastoidectomy. The audiological assessment showed a marked and statistically significant improvement of preoperative ABG from 30 to 21 dB in addition to the improvement of preoperative AC from 42 to 33 dB. ABG of 20 dB or less was achieved in 50% of the ears. No reaction occurred to GIC in all the ears. Conclusions: Retrograde mastoidectomy with canal wall reconstruction with bone graft was associated with a low rate of recidivism and significant improvement of the hearing. GIC is safe and effective in stabilization of bone graft in canal wall reconstruction.