Synopsis on Comparsion of canal wall up and canal wall down in achieving dry middle ear cavities.
|Introduction / Background
Canal wall up and canal wall down mastoidectomy represent two surgical approaches to middle ear cleft pathology.1The surgical treatment in the management of the middle ear cholesteatoma has been the matter under debate for years.2,3Various surgical techniques have been adovcated to treat aural cholesteatoma , but the controversy over open or closed procedure for cholesteatoma surgery is still far from resolution.4, 5Beside the eradication of disease and prevention of future cholesteatoma development the surgical procedures for middle ear cholesteatoma are designed to attain some other goals_ to achieve dry ear free from otorrhea and to stabilize or improve hearing.6,7 Canal wall down mastoidectomy is an adequate treatment for chronic otitis media with cholesteatoma and anatomic and functional results are also satisfactory.8It is recomended that wide meatoplasty in canal wall down technique should be done as it ensures a possible one time treatment.9 Variable techniques have been used to achieve dry disease free ear by obliteration of mastoid cavity by using flexible composite sheetsi.e hydroxylapatite and polymer9,periosteal_pericranial flap10,temporalis fascial flap,autogenous11 cranial bone pate.12 In canal wall up technique ,there is more chance of recurrence of the disease b/c cholesteatoma has tendeny to recur if it is not properly eradicated.13studies have shown that mastoid and epitympanic obliteration is an effective option for preventing a retraction pocket and cholesteatoma recurrence in patient.14 The purpoted significance of this study is to compare the outcome of canal wall up and canal wall down in attaining dry middle ear cavities.Patient will be prevented from life threating complications.The procedure showing beter results then can be applied to the patients in future.
The objective of this study is to comapare the efficacy of canal wall up and canal wall down mastoidectomy in achieving dry middle ear cavities.OPERATIONAL DEFINITION.
Dry middle ear cavity will be determined by aural speculum under microscope.
Canal wall up procedure:
Removal of mastoid ear cells,while retaining the posterior canal wall.
Canal wall down procedure:
Posterior bony meatal wall and the outer attic wall will be removed and the attic , aditus and antrum together with the mastoid antrum and air cell system will be exteriorzed to the external auidatory meatus.
|Material and Methods|