Open and closed cavity mastoid operations: comparing early hearing results

Area of Science:

• Otolaryngology
• Audiology
• Surgical Outcomes

Background:

• Mastoidectomy is a surgical procedure to remove diseased mastoid air cells.
• Open and closed cavity techniques are two common approaches with differing post-operative management.
• Evaluating audiological outcomes is crucial for patient management and surgical technique selection.

Purpose of the Study:

• To compare the 1-year post-operative audiological results between open and closed cavity mastoidectomy.
• To assess the impact of surgical technique on air-bone gap (ABG) closure and hearing success.
• To determine if middle ear pathology influences hearing outcomes in either mastoidectomy type.

Main Methods:

• Prospective review of a single surgeon's case series (n=128) at two district general hospitals.
• Inclusion criteria: patients with 1-year post-operative hearing results after open or closed cavity mastoidectomy.
• Outcome measures: preoperative and postoperative air-bone gap (ABG), Belfast rule of thumb for surgical benefit.

Main Results:

• No statistically significant difference in mean post-operative ABG between open (24 dB) and closed (21 dB) cavity mastoidectomy (p=0.12).
• Higher percentage of patients achieving ABG ≤ 20 dB in closed cavity (41%) compared to open cavity (21%).
• 79% of patients in both groups achieved successful hearing results per the Belfast rule of thumb; pathology did not significantly influence outcomes.

Conclusions:

• One-year post-operative audiological results show no statistical difference between open and closed cavity mastoidectomy.
• Closed cavity mastoidectomy demonstrated a trend towards better ABG closure (≤ 20 dB).
• Middle ear pathology did not significantly impact hearing outcomes between the two surgical techniques.