Surgical Results of Endoscopic Mastoid Reconstruction Techniques

By June 7, 2019

Chang, Wai Tsz1; Tong, Michael Chi Fai1
1 Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong.

Introduction:
Post mastoidectomy or autocavity with mastoid bowl was a common condition seen in ENT outpatient clinic. Chronic discharge of the mastoid cavity with a re-existing wide meatoplasty was a major issue to address. A dry ear will facilitate hearing aid prescription, frequency of attendance to ENT clinic and risk of major infection.

Study Design:
Retrospective case review
Setting:
Tertiary referral center; Regional University Hospital
Patients:
Patient with chronic discharging mastoid; underwent endoscopic trascanal mastoid reconstruction surgery as part of their surgical treatment
Intervention:
To evaluate the results after endoscopic transcanal mastoid reconstruction to achieve dry ear and to minimize surgery-related morbidities.
Main Outcome Measures:
Rate of achieving dry ear; hearing gain after surgery.

Result:
Recurrence of cholesteatoma was identified in 3 out of 10 patients (30%); Adjunctive ossiculoplasty was performed in 9 out of 10 patients (90%); Complete dry ear in follow up was achieved in 8 out of 10 patients (80%). Mean hearing was improved in 3 out of 10 patients(30%).  Those with recurrent discharge does not related to recurrence. The technical modifications that evolved with increasing experience are described.

Conclusion:
The transcanal endoscopic mastoid reconstruction technique was described and noted successful achieving a dry cavity in 80% of patient. This is a promising result and be applied to patient with recurrent discharging ears post mastoidectomy to achieve. Minimal invasive approach can be achieved with no external wound with current method.