Mastoid Obliteration: A Comparison of Two Techniques

To compare the outcome and efficacy of mastoid obliteration following canal wall down mastoidectomy, using two different materials such as bone pâté and bioactive glass granules. This is a prospective, randomized, single blind comparative study conducted for a period of 2 years in a tertiary care center. The patients were divided into two groups A and B. In group A, the mastoid was obliterated with bone pâté and inferiorly based musculoperiosteal flap and in group B, bioactive glass with inferiorly based musculoperiosteal flap. They were assessed post operatively at 4th, 12th and 24th week for cavity healing (merchant et.al., score), subjective satisfaction and at the 24th week the effectiveness of obliteration was assessed visually by oto endoscopy and HRCT was done additionally to assess the volume of external auditory canal. A total of 40 patients with chronic otitis media (Squamosal type) were included and divided into 2 groups. At the end of 4 weeks, bioactive glass had better healing, which was statistically significant. At the end of 24 weeks both groups had similar rate of healing. There was no difference in subjective satisfaction at end of 24 weeks. The patients in bioactive glass group had statistically better obliteration than Group A and the volume of the EAC was less in this group signifying better obliteration. The cavity healing were similar for both bone pâté and Bioactive glass at end of 24 weeks. Bioactive glass had better outcomes for effectiveness of obliteration compared to bone pâté.