Clinical Analysis of 22 Cases of Automastoidectomy

Abstract

Objective: Automastoidectomy is a destructive condition of the mastoid and middle ear cavity about which very little has been reported. 1) Know the clinical features and severities of automastoidectomy caused by chronic otitis media. 2) Evaluate the results of its surgical outcomes. Method: Retrospective study. Patients who visited outpatient clinic and were diagnosed with COM with automastoidectomy state by temporal bone CT from January 2003 to December 2011 were included in this study. All patients underwent surgery. Their postoperative states were evaluated at the outpatient clinic at least 6 months after surgery. Results: Two patients complained of facial palsy, 7 hearing disturbance, 10 otorrhea, and 3 otalgia. At physical examination, attic destruction and retracted tympanic membrane (TM) were observed in 12 patients, EAC destruction in 8, TM perforation in 4, and 1 had intact TM. All pathologic results were cholesteatoma. A total of 19 had canal wall down mastoidectomy, 2 had canal wall-up mastoidectomy, and 1 had subtotal petrosectomy. One had tympanoplasty type 1, 3 had columella over stapes head, 10 had interposition or columella over stapedial footplate and, 1 had tympanoplasty type 3. Overall hearing improvement rate was 9.0%. There was no recurrence. Conclusion: Automastoidectomy is a relatively rare condition of middle ear diseases. It could be caused by cholesteatomatous COM and non-cholesteatomatous COM. Hearing reconstructive procedures are generally not effective compared with other conditions. This study may be helpful to know the clinical features and surgical outcomes of this condition.