Outcome of Post-Operative Mastoid Cavity Obliteration with Autologous Adipose Tissue

Main Article Content

Rabi Hembrom
Satadal Mondal
Indranil Sen
Amit Chakrabarti
Rupam Sinha
Tapas Kumar Mahata
Aritra Bhattacharya
Swagato Roy

Abstract

Introduction


Mastoid operations have been in practice for over four centuries for suppurative conditions of the ear. Intact canal wall mastoidectomy has the advantage of better functional results while canal wall down mastoidectomy offers excellent exposure for disease eradication and post operative monitoring but is associated with significant cavity problems. In order to overcome the problems associated with canal wall down procedure while retaining its advantages the concept of mastoid cavity obliteration was introduced. This study analysed the outcomes of mastoid cavity obliteration and to assess the outcomes of mastoid cavity obliteration with autologous adipose tissue.


Materials and Methods


A prospective, experimental, randomized study was conducted over a period of 18 months among patients presenting with active squamous variety of Chronic Otitis Media. The patients were randomly allocated to two groups, A and B. Both groups underwent canal wall down Mastoidectomy followed by obliteration with autologous adipose tissue in Group B .


Results


In group A, the mean duration required for complete epithelialization was 10.8 weeks. In group B, the average time taken for complete epithelialization was 5.6 weeks. All cases had their graft intact at the end of 12 weeks. Debris was present in group A for a mean duration of 9.47 weeks. In group B, debris was found for a mean duration of 3.33 weeks. Patients from group A complained of discharge from their ears for a mean duration of 7.47 weeks. In group B the same symptom persisted over 3.33 weeks.


Conclusion


Cavity problems encountered is considerably less in the group obliterated with adipose tissue.

Article Details

How to Cite
1.
Hembrom R, Mondal S, Sen I, Chakrabarti A, Sinha R, Mahata TK, Bhattacharya A, Roy S. Outcome of Post-Operative Mastoid Cavity Obliteration with Autologous Adipose Tissue. BJOHNS [Internet]. 2020Aug.31 [cited 2024May4];28(2):138-43. Available from: https://bjohns.in/journal3/index.php/bjohns/article/view/331
Section
Main article
Author Biographies

Rabi Hembrom, Midnapore Medical College Vidyasagar Road Midnapore

Associate Professor

Midnapore Medical College and Hospital

Department of Otorhinolaryngology

Satadal Mondal, IPGMER, Kolkata

Associate Professor

I.P.G.M.E.R.

Department of Otorhinolaryngology

Indranil Sen, Midnapore Medical College Vidyasagar Road Midnapore

Professor and Head

Midnapore Medical College and Hospital

Department of Otorhinolaryngology

Amit Chakrabarti, Midnapore Medical College Vidyasagar Road Midnapore

R.M.O. cum clinical tutor

Midnapore Medical College and Hospital

Department of Otorhinolaryngology

Rupam Sinha, Khatra Sub Division Hospital Bankura

Senior Resident

Tapas Kumar Mahata, Midnapore Medical College Vidyasagar Road Midnapore

Junior Resident

Aritra Bhattacharya, Midnapore Medical College Vidyasagar Road Midnapore

Junior Resident

Swagato Roy, Midnapore Medical College Vidyasagar Road Midnapore

Junior Resident

References

Gopen Q. Pathology and clinical course of the inflammatory diseases of the middle ear. In: Gulya AJ, Minor LB, Poe DS, editors. Glasscock-Shambaugh Surgery of the Ear. 6th ed. Shelton, Connecticut: People’s Medical Publishing House-USA; 2010

Nadol JB. The chronic draining ear. Current therapy in Otolaryngol Head Neck Surg. 1987;18:18-22

Browning GG. Merchant SN, Kelly G, Swan IR, Canter R, McKerrow WS. Chronic otitis media. In: Gleeson M, editor. Scott-Brown’s Otorhinolaryngology, Head and Neck Surgery. 7th ed. Great Britain. Edward Arnold (Publishers) Ltd; 2008

Haynes DS, Wittkopf J. Canal-wall-Up Mastoidectomy. In: Gulya AJ, Minor LB, Poe DS, editors. Glasscock-Schambaugh Surgery of the Ear. 6th ed. Shelton, Connecticut: People’s Medical Publishing House-USA; 2010

Kveton JF. Open Cavity Mastoid Operations. In: Gulya AJ, Minor LB, Poe DS, editors. Glasscock-Schambaugh Surgery of the Ear. 6th ed. Shelton, Connecticut: People’s Medical Publishing House-USA; 2010

Rao U.S. Obliteration of mastoid cavity and reconstruction of attic area using conchal cartilage. Asian Pac. J. Health Sci. 2016; 3(1):140-3

Cho SW, Cho YB, Cho HH. Mastoid Obliteration with Silicone Blocks after Canal Wall Down Mastoidectomy. Clinical and Experimental Otorhinolaryngology 2012; 5(1):23-7

Uçar C. Canal wall reconstruction and mastoid obliteration with composite multifractured osteoperiosteal flap. European Archives of Oto-Rhino-Laryngology 2006; 263(12):1082-6

Alves RD, Cabral Junior F, Fonseca AC de O, Bento RF. Mastoid Obliteration with Autologous Bone in Mastoidectomy Canal Wall Down Surgery: a Literature Overview. International Archives of Otorhinolaryngology 2016; 20(1):76-83

Singh M, Jain S, Rajput R, Khatua RK, Sharma D. Retrospective and Prospective Study of Singapore Swing Method on Healing of Mastoid Cavity. Indian J Otolaryngol Head Neck Surg. 2010; 62: 365-71

Lee HJ, Chao JR, Yeon YK, Kumar V, Park CH, Kim HJ, Lee JH. Canal Reconstruction and Mastoid Obliteration Using Floating Cartilages and Musculoperiosteal Flaps. Laryngoscope 2017 May;127(5):1153-60

Preetam C, Verma R, Thakar A, Sikka K. Tympanomastoid obliteration for recalcitrant attico-antral chronic suppurative otitis media. Indian J Otol. 2011;17:26-9

Bhandary S, Paudel D, Chettri ST, Natesh VN, Shilpakar SL, Sah BP, Pokharel A. Obliteration of Mastoid Cavity with Temporalis Muscle Pedicle and Abdominal Fat Graft and Compare the Efficacy of Each Method: A Prospective Randomized Clinical Trial. Otolaryngology Online Journal 2015; 5(3)

Deshmukh S, Sharma A, Dabholkar J. Mastoid cavity obliteration: Our experience. Otolaryngologia Polska 2012; 66:379-81

Ravi K, Kumar SK. Mastoid cavity obliteration in open cavity type (MRM) with fibro fatty tissue and subcutaneous periosteal flaps study conducted at RIMS college Ongole ENT department 2015-2016. Journal of Dental and Medical Sciences. 2016;15(6):63-70

Montandon P, Benchaou M, Guyot JP. Modified canal wall-up mastoidectomy with mastoid obliteration for severe chronic otitis media. ORL J Otorhinolaryngol Relat Spec. 1995; 57(4):198-201.

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