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Updated: Mar 15, 2026
Endaural Endoscopic Atticoantrotomy Retrograde Mastoidectomy using a Constant Suction Bone-drilling Technique
Published on: May 23, 2021
Long-term Outcomes After Secondary Mastoid Obliteration
Matthew D Cox1, Quinn A Dunlap, Aaron Trinidade
1Department of Otolaryngology-Head and Neck Surgery, Division of Otology and Neurotology, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Objectives:
To assess long-term outcomes after secondary mastoid obliteration.
Study Design:
Case series with chart review.
Setting:
Tertiary care center.
Patients:
Adult patients (20-80 yr of age) undergoing secondary mastoid obliteration.
Outcome Measures:
Hearing results (improvement in pure-tone average air-bone gap [PTA-ABG] from baseline) at the time of postoperative audiometry and at least 5 years after surgery, anatomic outcomes (rate of successful tympanic membrane graft healing), and the incidences of observed complications.
Results:
An average improvement in PTA-ABG by 16.9 dB (p = 1.8 × 10) was noted. Postoperatively, the PTA-ABG was successfully closed to ≤20 dB in 39.5% (17/43) of patients. The average final PTA-ABG (obtained at least 5 years after surgery) was 25.3 dB, which was also a significant improvement over the preoperative baseline PTA-ABG (p <<< 0.01). Significant complications were observed in 14.0% (6/43) of patients, with 9.3% (4/43) requiring a subsequent surgery. Although 69.8% (30/43) of patients experienced otorrhea preoperatively, otorrhea was only observed in 4.7% (2/43) at any point in time postoperatively.
Conclusion:
Secondary mastoid obliteration with reconstruction of a more natural posterior canal wall, cartilage tympanoplasty, and ossicular chain reconstruction is a hybrid technique that allows for creation of a safe, dry ear with significant, long-term improvement in hearing and functional outcomes in patients with unstable mastoid cavities.
