The exenterated mastoid: a problem of ear surgery

The exenterated mastoid behind an intact posterior ear canal wall is one of the preconditions for the development of hidden cholesteatoma recurrences. Retraction pockets can develop into the cavity owing to persisting malfunction of the eustachian tube. Matrix inadvertently left in the tympanic space or in the mastoid process can grow into or in the cavity unnoticed. The way to avoid this nesting site is permanent obliteration of the mastoid process immediately after the eradication of the disease. Furthermore, the disadvantages of old radical operation cavities can be eliminated by secondary obliteration, connected with a revision and repair of the sound pressure transfer mechanism if necessary. It is important to use a nonresorbable obliteration material. We use methacrylate (Sulfix-6) for this purpose, so far without any negative consequences in the ears.