Tympanomastoidectomy canal wall reconstruction with mastoid obliteration

To describe the various techniques in performing a tympanomastoidectomy canal wall reconstruction with mastoid obliteration for surgical management of chronic otitis media and cholesteatoma, and to assess the outcomes and complications compared to the more traditional canal wall up and canal wall down surgical techniques. Additionally, the purpose of this review is to highlight the versatility and novelty of this approach in addressing other middle ear pathologies such as glomus tympanicum.

As canal wall reconstruction (CWR) with mastoid obliteration (MO) has become more recognized, several modifications and variations in the technique have been described with good results - from how the canal wall is taken down, to what material is being used for reconstruction and obliteration, including both autologous and alloplastic materials. Indications for the use of CWR with MO have also expanded to include those with large glomus tympanicum or patients needing canal wall down (CWD) reversal.

CWR with MO is a useful alternative approach to addressing middle ear pathology, particularly cholesteatoma, as it provides enhanced visualization seen with CWD while also preserving native EAC anatomy. Reconstruction can be performed with a variety of materials, each with relative advantages and disadvantages.