The important issues of mastoidoplasty during reconstructive operations on the middle ear

Abstract

Surgical treatment of patients suffering from chronic suppurative otitis media is an important issue of otiatry. The high frequency of unsatisfactory results of surgical treatment of patients with chronic suppurative otitis media, the lack of optimal (generally accepted) approach to their surgical treatment, the persistent hearing loss after sanitizing operations determines the relevance of this problem: the need to identify the causes of unsatisfactory results, develop an algorithm and new methods of surgical treatment. ENT physicians generally believe that the obliteration of the mastoid cavity, applied after modified radical mastoidectomy, is sufficient to prevent such problems as otorrhea, infection, the proliferation of granulation tissue and hearing loss. Obliteration can be performed using various methods and materials, including autologous bone chips and dust, hydroxyapatite, cartilage, and periosteal-pericranial flaps. Obliteration of the mastoid cavity was proposed to facilitate healing and epithelialization and can be performed during the initial procedure of the canal plasty or during the secondary delayed procedure. Obliteration reduces the volume of the mastoid process cavity, thereby reducing the size of the lumen, which is necessary for effective control of the disease. Reduction of depth and the total volume of the mastoid cavity also provides the elimination of the areas with permanent accumulation of moisture, theoretically reducing the frequency of the necessary cleaning.