Clinical indications for canal wall-down mastoidectomy in a pediatric population

Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
Alexander J OsbornAdrian L James

Abstract

To establish clinically derived indications for performing canal wall-up or canal wall-down surgery when treating children with cholesteatoma. Case series with chart review. Tertiary care academic pediatric otolaryngology practice. Retrospective review of 420 children who underwent 700 procedures for cholesteatoma between 1996 and 2010. The canal wall was preserved in 89.5% of cases. Common reasons for removing the canal wall were to provide access to the disease, extensive erosion of key structures, and the desire to avoid further surgery. The mean pure-tone average (PTA) for the canal wall-up group was 30 dB, whereas the canal wall-down group had a mean PTA of 45 dB. A matched-pairs analysis demonstrated that the better performance of the canal wall-up group was independent of preoperative hearing levels. Furthermore, although the presence of the stapes did influence hearing results, the canal wall-up procedure yielded better results even when the condition of the stapes was taken into account. The number needed to treat with canal wall-up to prevent 1 case of hearing loss (ie, mean threshold >30 dB) would be around 6. The need for revision surgery was higher in the canal wall-up group (51%) compared with the canal wall-down ...Continue Reading

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Citations

Jul 23, 2013·Current Opinion in Otolaryngology & Head and Neck Surgery·John L DornhofferMichael B Gluth
Sep 3, 2013·Current Opinion in Otolaryngology & Head and Neck Surgery·Adrian L James, Blake C Papsin
Apr 17, 2013·European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery·A D Olusesi, E Opaluwah
Jun 17, 2014·Auris, Nasus, Larynx·Yuka MoritaSugata Takahashi
Nov 1, 2015·International Journal of Pediatric Otorhinolaryngology·Nandini GovilRobert F Yellon
Apr 10, 2013·International Journal of Pediatric Otorhinolaryngology·Thomas N RothMarco D Caversaccio
Apr 10, 2013·Otolaryngologic Clinics of North America·Adrian L James
Jan 1, 2016·Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology·Adrian L JamesBlake C Papsin
Jan 10, 2016·International Journal of Pediatric Otorhinolaryngology·J K McGuireJ J Fagan
Sep 18, 2014·European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery·Chin-Lung KuoAn-Suey Shiao
Aug 27, 2014·The Laryngoscope·Nikolaus E WolterBlake C Papsin
Nov 22, 2014·European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery·Lela MigirovMichael Wolf
Mar 14, 2017·Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology·Gavin J le NobelAdrian L James
Aug 5, 2019·European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery·Eran GliksonYisgav Shapira
Jul 10, 2019·Otolaryngologic Clinics of North America·Kimberly LuuKay W Chang

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