Learning Objectives:
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1. Use of cartilage in MCO and PCR.
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2. Effect on QOL of patients after using cartilage for MCO/PCR.
Introduction: Otologists have tried indigenous alterations in mastoidectomy technique to improve outcomes of chronically discharging ear(CDE). Currently, the surgical management of CDE entails modified radical mastoidectomy(MRM). However it leaves cavity open & prone for discharge along with problems such as wax formation & giddiness.Literature review suggests that mastoid cavity obliteration(MCO)/posterior wall reconstruction(PWR) has low complication rates. Various materials such as cartilage,bone cement & soft tissue are commonly used.
Objective: Pts with MCO require less cavity care and thus decreased dr dependence. Our study was aimed at finding pt satisfaction and QOL after MCO using cartilage. It was also directed to find out post-op dry ear, wax problems, dizziness & recurrence.
Methods: In our cohort study, 29pts with CDE underwent revision mastoidectomy with MCO/PCR during Jul'11-Jun'15. They were followed at 6wks, 4, 6 & 12mths post-op.Symptoms were noted in pt files during followup visits & collated on excel chart. QOL was assessed using Glasgow Benefit Inventory Score. Response was obtained by posting proformas to pts.Ethical approval was obtained from trust R&D.
Results: The procedure was successful in improving QOL in majority. 26/29 pts reported dry ears. 2 pts continued to have discharge &1 underwent repeat surgery. Frequency of clinic visits has reduced significantly. >90%pts reported significant improvement in QOL & less visits to GP surgery.
Conclusion: The outcome and QOL improvement after MRM/PCR using cartilage is satisfactory. Frequently encountered problems of chronically discharging ear, wax and dizziness are reduced.
Keywords: Chronic otitis media, mastoid cavity obliteration, cartilage graft, QOL, Glasgow Benefit Inventory Score.
