Results of mastoid operations in various chronic ear diseases

A study of mastoid operations undertaken for various chronic middle ear entities, using closed and open techniques, revealed the following: 1. Marsupialized mastoid balls were found less disappointing than often considered; small cavities were dry in 90 percent and large ones in 70 percent of cases. 2. Residual disease (epidermoid cysts) appeared in 27 percent of the CAT-operated ears and in 13 percent when the open technique was employed. 3. Residual disease appeared twice as often when the primary disease involved the tympanic cavity and in young patients than when the attic and mastoid were exclusively involved or in older patients. 4. Residual disease did show up only in epidermoid ("attic") cholesteatomas, but not when the primary pathology was a retraction pocket (sinus tympani) cholesteatoma. 5. Up to 56 percent of the CAT-operated ears showed small, medium, or large retraction pockets. However, only large retraction pockets were of clinical significance. 6. The posterior wall, when preserved, atrophied to an important degree in about a tenth of the cases. 7. Significant atelectasis appeared in about a third of the ears once the membrana tensa was preserved, that is, in CAT or conservative radical operations. 8. About 10 percent of CAT operations performed in children may lead to an episode of acute mastoiditis.