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.

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
Tertiary referral center; Regional University Hospital
Patient with chronic discharging mastoid; underwent endoscopic trascanal mastoid reconstruction surgery as part of their surgical treatment
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.

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.

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.