Epitympanoplasty with mastoid obliteration technique: a long-term study of results.

Objective: To report the long-term results of epitympanoplasty with mastoid obliteration technique.

Methods: Two hundred adult cases had undergone epitympanoplasty with mastoid obliteration from December 1994 to May 2003. The mean postoperative observation period was 91 months, with a minimum of five years. Epitympanoplasty with mastoid obliteration technique has four major procedures: the widening of the external auditory canal and removal of the scutum; preservation of the posterior canal wall; epitympanoplasty; and mastoid obliteration. We examined postoperative complications and hearing outcomes.

Results: There was no retraction pocket formation and recurrence of cholesteatoma. Residual cholesteatoma in the tympanic cavity was seen in 10 cases (5%) and three cases were seen in the mastoid cavity (1.5%). Other complications were otorrhea (15 cases), perforation (8 cases), material extrusion (6 cases), and posterior auricular infection (4 cases). The average preoperative pure tone air-bone gap, postoperative pure tone air-bone gap, and air-bone gap closure were 31.5 +/- 12.4 dB, 25.3 +/- 12.2 dB, and 6.2 +/- 12.6 dB, respectively. There were significant differences between the preoperative and postoperative values (P < 0.01).

Conclusions: The authors believe that epitympanoplasty with mastoid obliteration technique can combine the advantages of canal wall down and canal wall up techniques while improving their shortcomings.