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Ears with Cholesteatoma: Outcomes of Canal Wall Up and Down Tympano-Mastoidectomies—A Comparative Prospective Study

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Abstract

This prospective study has been carried out to observe the outcomes of canal wall up (CWU) and canal wall down (CWD) Tympano-mastoidectomies in ears with cholesteatoma. Outcomes of the procedures have been done in terms of recurrence of cholesteatoma, complications, graft uptake rates and post-operative hearing gain. This study was carried out in the Department of Otorhinolaryngology of a reputed tertiary teaching hospital of North India from January 2016 to June 2020, with a mean follow-up of 32 months. The study included 100 patients of otitis media with cholesteatoma. In Canal Wall Up Tympano-mastoidectomy (CWUT) group, the number of males and females were 22 each. On the other hand, 36 males and 20 females underwent Canal Wall Down Tympano-mastoidectomy (CWDT). Each surgery was done as a single-staged and at the end of the surgical procedure angled oto-endoscopes were used for ensuring complete removal of the disease. Though there is no statistically significant difference in recurrence of cholesteatoma and complications rate in CWU and CWD Tympano-mastoidectomy techniques, but CWUT is superior to CWDT in terms of better graft uptake (p = 0.0156), and better average audiological gain (8.56 ± 0.93 dB) with p value = 0.0315. A diligent post-operative follow-up is must for assessing the outcomes of different types of mastoidectomies. This study shows no statistical difference in the disease recurrence and complication rates between Canal Wall Up and Down Tympano-mastoidectomies, though the anatomical changes and creation of the mastoid cavity in canal wall down procedure may affect the graft uptake and post-operative hearing gain. Use of Oto-endoscopes in cholesteatoma surgery helps in improving the outcomes of both techniques and thus recommended if the facility for the same is available.

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Funding

This study was not funded by any agency.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Faculty of Medicine, Aligarh Muslim University, Aligarh, UP, 202002, India

    Mehtab Alam & Kamlesh Chandra

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  1. Mehtab Alam
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  2. Kamlesh Chandra
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Correspondence to Mehtab Alam.

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Place of Study This study was carried out in the Department of Otorhinolaryngology, Jawaharlal Nehru medical College, A.M.U., Aligarh, from January 2016 to June 2020, with a mean follow-up of 32 months.

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Alam, M., Chandra, K. Ears with Cholesteatoma: Outcomes of Canal Wall Up and Down Tympano-Mastoidectomies—A Comparative Prospective Study. Indian J Otolaryngol Head Neck Surg 74 (Suppl 1), 730–736 (2022). https://doi.org/10.1007/s12070-021-02549-1

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  • DOI: https://doi.org/10.1007/s12070-021-02549-1

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