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Does canal wall down mastoidectomy benefit syndromic children with congenital aural stenosis?
Phayvanh P Sjogren1, Richard K Gurgel1, Albert H Park2
1Division of Otolaryngology - Head and Neck Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA.
Insights
Canal wall down mastoidectomy offers long-term benefits for children with congenital aural stenosis. This surgical approach improves the ease of office examinations for syndromic children with poorly pneumatized mastoids.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Genetics
Background:
- Congenital aural stenosis presents challenges in pediatric audiology and otology.
- Syndromic conditions frequently involve craniofacial anomalies, including aural stenosis.
- Effective management strategies for pediatric aural stenosis are crucial for audiological assessment and care.
Purpose of the Study:
- To evaluate the long-term efficacy of canal wall down mastoidectomy in children with congenital aural stenosis.
- To assess the impact of this surgical procedure on the ability to perform routine otological examinations.
Main Methods:
- A retrospective case series was conducted over a twelve-year period.
- The study included children with congenital aural stenosis who underwent canal wall down mastoidectomy at a tertiary children's hospital.
- Data analysis focused on surgical outcomes, complications, and ease of post-operative examination.
Main Results:
- Thirteen children underwent twenty canal wall down mastoidectomies for aural stenosis.
- All thirteen ears with pre-operative visualization difficulties showed improved ease of office examination post-surgery.
- The mean follow-up was 4.9 years, with only one revision surgery required and all canals patent at the last visit. No facial nerve injury or CSF leaks occurred.
Conclusions:
- Canal wall down mastoidectomy is a beneficial procedure for syndromic children with congenital aural stenosis and poorly pneumatized mastoids.
- The surgery significantly enhances the ability to conduct routine otological examinations, improving patient management.
- This surgical approach demonstrates a favorable safety profile with low complication rates.
Objectives:
To determine whether a canal wall down mastoidectomy can provide long-term benefit for children with aural stenosis.
Methods:
Retrospective case series of children with congenital aural stenosis having undergone a canal wall down mastoidectomy over a twelve-year period at a tertiary children's hospital.
Results:
Data from thirteen children who underwent a total of twenty canal wall down mastoidectomies for aural stenosis were reviewed. The mean age at surgery was 7.1 years (range, 3.3-12.3 years). All patients had genetic syndromes including Trisomy 21 (n = 7), Trisomy 21 and Pierre Robin sequence (n = 1), Angelmann (n = 1), Cri-du-chat (n = 1), Branchio-oto-renal syndrome (n = 1), Spina bifida (n = 1) and Nager syndrome (n = 1). Seven (54%) children underwent bilateral canal wall down mastoidectomies. All thirteen ears that could not be visualized preoperatively had improved ease of office examination following surgery. Only one patient required revision surgery and all canals were patent at the last clinic visit. The mean follow-up was 4.9 years. There were no cases of facial nerve injury or cerebrospinal fluid leak.
Conclusion:
Syndromic children with congenital aural stenosis with poorly pneumatized mastoids may benefit from canal wall down mastoidectomy to improve ease of office examinations.
