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Subtotal Petrosectomy With Blind Sac Closure of the External Auditory Canal – Indications and Results

Presenting Author: Udi Katzenell

Published online by Cambridge University Press:  03 June 2016

Udi Katzenell  and
Doron Halperin
Udi Katzenell
Affiliation:
Kaplan Medical Center
Doron Halperin
Affiliation:
The Department of Otolaryngology Head and Neck Surgery / Kaplan Medical Center / Affiliated to the Faculty of Medicine of the Hebrew University of Jerusalem
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Abstract

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Learning Objectives:

Introduction: Subtotal petrosectomy and blind sac closure of the auditory canal (STP) includes a canal wall down mastoidectomy with exenteration of all air cells, obliteration of the middle ear cleft with fat or temporalis muscle or a biocompatible material and closure of the external auditory canal. The indications for STP are weeping mastoid cavities, temporal bone malignancies, CSF leak and lateral base of skull surgeries. Hearing rehabilitation with a bone conduction hearing device or a cochlear implant can be offered. The aim of this study is to review the indications, results and hearing rehabilitation of the patients who underwent STP in our department.

Methods: All charts of patients who underwent STP between October 2011 and December 2015 were reviewed and analyzed.

Results: During this period 20 patients underwent STP. The average age was 46.9(13–81). 6 patients had cholesteatoma of them 5 were deaf in the operated ear. 1 patient had an encephalocele in a previously operated ear. 13 patients had a weeping mastoid cavity with no cholesteatoma. 4 patients had a Bone Anchored Hearing Aid and One patient had a Bonebridge implanted. 2 patients had a cochlear implant in a deaf ear. 1 patient had surgery for external auditory canal carcinoma. One patient with a weeping cavity had a recurrent infection in the mastoid cavity, the miatus opened and discharge persisted. All other operated patients ears stopped discharging therefore the success rate in this series is 95%. There were no major complications after surgeries. All patients who had a bone anchored hearing device or a cochlear implant presented benefit from their devices.

Conclusion: Patients with weeping cavities are debilitated due to water precautions, vestibular effect, the reduced hearing and the discharge that can be extremely disturbing. A debilitating weeping cavity which does not respond to medical treatment is a surgical disease. In such patients STP with hearing rehabilitation should be suggested.