Comparative Study of Various Techniques of Mastoid Obliteration following Canal Wall Down Mastoidectomy

The primary objective of mastoid obliteration is the eradication of the disease and prevention of its recurrence. We intend to evaluate the impact of mastoid obliteration using autologous materials on the achievement of a dry mastoid bowl and frequency of maintenance care and hearing outcome of the operated ear. This was a hospital-based, non - randomized, prospective study. The study was performed over a period of 2 years. The study was performed in the Department of ENT of a tertiary care teaching hospital. Patients of chronic otitis media - squamosal type underwent canal wall down mastoidectomy and patients were divided into 2 groups of obliterated and non-obliterated. The canal wall obliterated patients were further compared in 3 groups based on the technique of mastoid obliteration used - bone dust, musculo-periosteal flap and cartilage graft. 6 months post-operative mastoid cavity epithelisation based on oto-microscopy and hearing outcome based on pure tone audiometry findings were compared. Majority of patients at 6-months follow-up found that epithelization was most common status of mastoid cavity with musculoperiosteal flap and discharge was commonest with cartilage graft. Mastoid obliteration with autologous materials is a safe and effective method to achieve a dry, safe and useful ear. In this study, musculo-periosteal flap being significantly better in terms of a well epithelized cavity and hearing outcome.