Long-term Outcomes After Secondary Mastoid Obliteration

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Abstract

Objectives:

To assess long-term outcomes after secondary mastoid obliteration.

Study Design:

Case series with chart review.

Setting:

Tertiary care center.

Patients:

Adult patients (20–80 yr of age) undergoing secondary mastoid obliteration.

Outcome Measures:

Hearing results (improvement in pure-tone average air-bone gap [PTA-ABG] from baseline) at the time of postoperative audiometry and at least 5 years after surgery, anatomic outcomes (rate of successful tympanic membrane graft healing), and the incidences of observed complications.

Results:

An average improvement in PTA-ABG by 16.9 dB (p = 1.8 × 10−9) was noted. Postoperatively, the PTA-ABG was successfully closed to ≤20 dB in 39.5% (17/43) of patients. The average final PTA-ABG (obtained at least 5 years after surgery) was 25.3 dB, which was also a significant improvement over the preoperative baseline PTA-ABG (p <<< 0.01). Significant complications were observed in 14.0% (6/43) of patients, with 9.3% (4/43) requiring a subsequent surgery. Although 69.8% (30/43) of patients experienced otorrhea preoperatively, otorrhea was only observed in 4.7% (2/43) at any point in time postoperatively.

Conclusion:

Secondary mastoid obliteration with reconstruction of a more natural posterior canal wall, cartilage tympanoplasty, and ossicular chain reconstruction is a hybrid technique that allows for creation of a safe, dry ear with significant, long-term improvement in hearing and functional outcomes in patients with unstable mastoid cavities.

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