Sonvane Krutika, Raval Jayman B, Aiyer R G
Department of E.N.T. and Head-Neck Surgery, Baroda Medical College and S.S.G. Hospital, Vadodara, Gujarat India.
Indian J Otolaryngol Head Neck Surg. 2023 Sep;75(3):1631-1638. doi: 10.1007/s12070-023-03704-6. Epub 2023 Mar 22.
To identify the causes of failure of the canal wall down mastoidectomy and evaluate the causes for discharging mastoid cavity and to address the causes of failure of previous surgery to minimize the Revision surgery.
This was a prospective and retrospective observational study conducted at a tertiary care hospital from May 2019 to December 2021. Total 20 Patients (11 male & 9 female) with age group (0-60 years) who previously underwent canal wall down mastoidectomy and presented with complaints of persistent ear discharge were included. All patients underwent otoscopic, oto-endoscopic and microscopic examination.
Out of 20 cases,13 cases had residual/recurrent cholesteatoma, 11 cases had narrow meatoplasty and 9 cases had high facial ridge.Other causes for failure are graft defect, incomplete removal of anterior and posterior buttress.
Recurrent/residual cholesteatoma and Narrow meatoplasty are most common cause for failure of previous surgery. Persistent granulation at un-exenterated area was the most common cause for suppuration. Regular follow up and cleaning of the debris from cavity enhances the epithelialization and healing of the cavity.
确定开放式乳突根治术失败的原因，评估乳突腔流脓的原因，并找出既往手术失败的原因，以尽量减少翻修手术。
这是一项于2019年5月至2021年12月在一家三级护理医院进行的前瞻性和回顾性观察研究。纳入了20例（11例男性和9例女性）年龄在0至60岁之间、既往接受过开放式乳突根治术且有持续性耳流脓主诉的患者。所有患者均接受了耳镜、耳内镜和显微镜检查。
20例病例中，13例有残留/复发性胆脂瘤，11例外耳道成形术狭窄，9例有高位面神经嵴。其他失败原因包括移植物缺损、前后骨桥切除不完全。
复发性/残留性胆脂瘤和外耳道成形术狭窄是既往手术失败的最常见原因。未彻底清除区域的持续性肉芽组织是化脓的最常见原因。定期随访并清理乳突腔内的碎屑可促进腔上皮化和愈合。
