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Author:
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N.B. Prahlada, Karnataka ENT Institute & Research Centr, Chitradurga, India |
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Co-author(s):
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Topic:
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Surgery |
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Keywords:
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Perichondrial-periosteal flap, Conchal Cartilage, Cholesteatoma, Cavity Obliteration |
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OBJECTIVES : Considering patients preferences, financial limitations and cost effectiveness, the optimal treatment for cholesteatoma must be one operation, provided it achieves a dry safe ear. Advantages of Canal wall down surgery with full cavity obliteration have been very well established. Hereby we present and assess a surgical technique designed to minimize the known causes of a discharging mastoid cavity following canal wall down procedure for Cholesteatoma.
METHODS : In this prospective study of 68 patients in the age group of 15 to 63 years, with cholesteatoma and without complications were included. All patients underwent open mastoidectomy procedure, cavity obliteration and wide concho-meatoplasty procedure. Posteriorly based Perichondrial-periosteal flap and conchal carilage were used to obliterate the mastoid cavity. Various components of the three steps: open mastoidectomy, meatoplasty and cavity obliteration are done with post-aural approach and each step is inter-related and complements each other.
RESULTS : This technique was successful in obliterate the mastoid cavity which was dry in 67 (98%) patients with dry tympanic membrane perforations in 2 (2.94%) patients. Results with this technique are slightly better than various other flaps used for cavity obliteration. Experience with Conchal cartilage as obliteration material is similar to other studies.
CONCLUSIONS : The surgical technique presented here is easy to perform, less time consuming, easily reproducible, allows fast healing of the cavity, helps in improving the hearing and minimizes the postoperative cavity care.
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