Learning Objectives: To review the rationale, technique & outcomes in mastoid cavity obliteration.

Introduction: Canal wall down (CWD) surgery is associated with lower rates of residual/recurrent disease. CWD surgery followed by mastoid cavity obliteration is one potential method of reducing the burden of managing the open cavity. We present our results using BonAlive^® Granules for mastoid cavity obliteration.

Methods: Retrospective chart review and telephone survey.

Results: Between 2012–2015 we used this technique in a cohort of 20 patients; 16 male and 4 female. Mean age was 46 (median 47, range 32–67). Mean follow up was 19 months (median 15, range 7–46). Recurrence rate was 5% (1/20) of patients. In this case a small attic pearl was noted and this was managed on an out-patient basis. 10% (2/20) patients reported occasional discharge whereas in the remaining 90% (18/20) the ears were completely dry. We also conducted a telephone survey of patients using the Glasgow Benefit Inventory (GBI) with 18/20 patients responding. Mean GBI score was 63 (median 65, range 49–67). 16/18 patients responding to the GBI survey reported a net benefit from their procedure. In 10% (2/20) patients the operated ear had a profound loss/dead ear pre-operatively. Audiological outcomes consisting of averaged thresholds at 0.5, 1, 2 & 4kHz were available for 15/18 of the remaining patients. Mean change in air conduction thresholds was 0db (median 0, range −25 – +25). Mean change in bone conduction thresholds was −2db (median −2, range −16- +15).

Conclusions: Mastoid cavity obliteration in our experience has been associated with excellent outcomes in terms of dry-ear rate and recurrence rate at median follow up of 15 months.