Hostname: page-component-76fb5796d-x4r87 Total loading time: 0 Render date: 2024-04-29T19:08:44.028Z Has data issue: false hasContentIssue false
  • English
  • Français

Surgical management of the discharging mastoid cavity

Published online by Cambridge University Press:  09 November 2023

R. P. Mills
Get access Rights & Permissions [Opens in a new window]

Abstract

A survey of 67 patients with 74 mastoid cavities has been carried out. During the study period they made a total of 126 cavity/outpatient visits. Thirty-five patients (56 per cent) had discharge from at least one cavity on at least one outpatient visit. At only 5 per cent of visits was the discharge classified as profuse. A retrospective study of 54 mastoid revision operations on 51 patients has been made. Overall 59 per cent of operations resulted in a dry ear. The best results were achieved by carrying out cavity revision combined with a meatoplasty (83 per cent dry ears). Cavity revision alone produced a dry ear in only 57 per cent of cases. The worst results were produced by soft tissue obliteration (33 per cent dry ears). This supplement also presents the early results of a prospective investigation of bone pate obliteration of mastoid cavities. Of the eight cases studied so far, five (63 per cent) have dry ears following surgery. Three of the patients in this group had undergone previous unsuccessful revision surgery using other techniques. Cavity revision with meatoplasty is the technique of choice for most patients, but mastoid obliteration offers potential advantages for younger patients, particularly those wishing to swim.

Type
Research Article
Information
The Journal of Laryngology & Otology , Volume 102 , Issue S16: Surgical Management of the Discharging Mastoid Cavity , 1988 , pp. 1 - 6
Copyright
Copyright © JLO (1984) Limited 1988

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

ENT Department, King's College Hospital, London. (Based on the winning entry for the 1987 Xoraed Prize.)

References

Beales, P. H. and Hynes, W. (1958) Rapid healing after mastoid surgery by the use of the post-auricular flap. Journal of Laryngology and Otology, 72: 888-901.CrossRefGoogle ScholarPubMed
Beales, P. H. (1959) The problem of the mastoid segment after tympanoplasty. Journal of Laryngology and Otology, 73: 527-531.CrossRefGoogle ScholarPubMed
Beales, P. H. (1962) Cerebral abcess after obliterative mastoid operation. Archives of Otolaryngology, 76: 123-125.CrossRefGoogle Scholar
Beales, P. H. (1969) Complications following obliterative mastoid operations. Archives of Otolaryngology, 89: 196-198.CrossRefGoogle ScholarPubMed
El Silimy, O., Smelt, G. J. C. and Bradley, P. J. (1986) Swimming with a mastoid cavity: What are the risks? Clinical Otolaryngology, 11: 209-212.CrossRefGoogle ScholarPubMed
Grote, J. J. and Kuijpers, W. (1983) The use of biomaterials in reconstructive middle-ear surgery. In: Biomaterials in reconstructive surgery, Ed. Ruben, L. R. C. V. Mosby, St Louis, 987-995.Google Scholar
Grote, J. J. and Van Blitterswijk, C. A. (1986) Reconstruction of the posterior auditory canal wall with a hydroxyapatite prosthesis. Annals of Otology, Rhinology and Laryngology, Suppl. 123: 6-9.CrossRefGoogle ScholarPubMed
Guilford, F. R. (1960) Controlled cavity healing after mastoid and fenestration operations. Archives of Otolaryngology, 71: 165-171.CrossRefGoogle ScholarPubMed
Guilford, F. R. (1961) Obliteration of the cavity and reconstruction of the auditory canal wall in temporal bone surgery. Transactions of the American Academy of Ophthalmology and Otolaryngology, 65: 114-122.Google Scholar
Janzen, V. D. (1981) Mastoid obliteration with primary ossicular reconstruction. Journal of Otolaryngology, 10: 321-324.Google ScholarPubMed
Kisch, H. (1928) Temporalis muscle grafts in the radical mastoid operation. Journal of Laryngology and Otology, 43: 735-736.CrossRefGoogle Scholar
Leonard, R. B., Sauer, B. W. and Hulbert, S. F. (1973) The use of porous ceramic to obliterate mastoid cavities. Journal of Biomedical Materials Research (Symp.), 4: 85-95.CrossRefGoogle Scholar
Meuser, W. (1984) Permanent obliteration of old radical cavities combined with tympanoplasty. Journal of Laryngology and Otology, 98: 31-35.CrossRefGoogle ScholarPubMed
Mosher, H. P. (1911) A method of filling the excavated mastoid with a flap from the back of the auricle. Laryngoscope, 21: 1158-1163.CrossRefGoogle Scholar
Ojala, K. and Palva, A. (1982) Late results of obliterative cholesteatoma surgery. Archives of Otolaryngology, 108: 1-3.CrossRefGoogle ScholarPubMed
Osborne, J. E., Terry, R. M. and Gandhi, A. G. (1985) Large meatoplasty technique for mastoid cavities. Clinical Otolaryngology, 10: 357-360.CrossRefGoogle ScholarPubMed
Palva, T. (1962) Reconstruction of the ear canal in surgery for chronic ear. Archives of Otolaryngology, 75: 329-334.CrossRefGoogle ScholarPubMed
Palva, T. (1973) Operative technique in mastoid obliteration. Ada Otolaryngologica, 75: 289-290.CrossRefGoogle ScholarPubMed
Palva, T., Karma, P., Karja, J. and Palva, A. (1975) Mastoid obliteration: Histopathological study of 3 temporal bones. Archives of Otolaryngology, 101: 271-275.CrossRefGoogle Scholar
Palva, T. (1982) Obliteration of the mastoid cavity and reconstruction of the canal wall. In: International Medical Reviews; Otolaryngology I: Otology. Eds. Gibb, A. G. and Smith, M. F. M., Butterworths, London, 19-29.Google Scholar
Plester, D. and Steinbach, E. (1977) Histologic fate of tympanic membrane and ossicle homografts. Otolaryngology Clinics of North America, 10: 487-499.CrossRefGoogle ScholarPubMed
Popper, O. (1935) Periosteal flap grafts in mastoid operations. South African Medical Journal, 9: 77-78.Google Scholar
Rambo, J. H. T. (1958) Musculoplasty, a new operation for suppurative middle-ear deafness. Transactions of the American Academy of Ophthalmology and Otolaryngology, 62: 166-177.Google ScholarPubMed
Reck, R. (1984) Bioactive glass ceramics in ear surgery. Laryngoscope, Suppl. 33: 1-54.CrossRefGoogle Scholar
Sade, J., Weinburg, J., Berco, E., Brown, M. and Halvey, A. (1982) The marsupialised (radical) mastoid. Journal of Laryngology and Otology, 96: 869-875.CrossRefGoogle ScholarPubMed
Shea, M. C. and Gardiner, G. (1970) Mastoid obliteration using homograft bone. Archives of Otolaryngology, 92: 358-365.CrossRefGoogle ScholarPubMed
Shea, J. and Hornsby, C. A. (1974) The use of Proplast (TM) in otologic surgery. Laryngoscope, 84: 1835-1845.CrossRefGoogle ScholarPubMed
Shiller, A. (1961) ‘Mastoid osteoplasty’ using autogenous cancellous bone. Journal of Laryngology and Otology, 75: 647-668.CrossRefGoogle Scholar
Thorburn, I. B. (1961) Experience with pedicled temporalis muscle flaps in radical mastoid and tympanoplasty operations. Journal of Laryngology and Otology, 75: 885-896.CrossRefGoogle ScholarPubMed
Wehrs, R. (1972) Reconstruction mastoidectomy with homograft knee cartilage. Laryngoscope, 82: 1177-1188.CrossRefGoogle ScholarPubMed
Wigand, M. E., Weidenbecher, M., Bumin, P. and Mollenhawer, H. W. (1974) Tympanoplastik nach radikaloperation: Mit konchen oder knorpel? Archiv fur Otolaryngologie, 207: 542-544.Google Scholar