Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-19T16:03:23.806Z Has data issue: false hasContentIssue false
  • English
  • Français

The effect of fascia and free skin graft on the healing of mastoid cavity after canal wall down mastoidectomy

Published online by Cambridge University Press:  06 October 2021

K R Bongale ,
V K Bhat  and
A M Shetty
K R Bongale
Affiliation:
Department of Otolaryngology, Head and Neck surgery, Karnataka Institute of Medical Sciences, Hubli, India
V K Bhat*
Affiliation:
Department of Otolaryngology, Head and Neck surgery, Karnataka Institute of Medical Sciences, Hubli, India
A M Shetty
Affiliation:
Department of Otolaryngology, Head and Neck surgery, Karnataka Institute of Medical Sciences, Hubli, India
*
Author for correspondence: Dr V K Bhat, Department of Otolaryngology, Head and Neck surgery, Karnataka Institute of Medical Sciences, Pune-Bangalore Rd, Vidyanagar, Hubli580021, India E-mail: vikram.ent@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

Post-mastoidectomy delayed cavity healing is a challenge to manage. This study aimed to cut down healing time with a simple technique (fascia with a skin graft) and compared it with controls without this technique.

Method

The current study was a prospective non-randomised controlled study, conducted in a tertiary referral hospital. Thirty cases and 30 controls with squamosal type chronic otitis media were studied.

Results

By the end of first month, 23.3 per cent of cases had healed compared with 3.3 per cent of controls. At the third month follow up, 83.3 per cent of cases and 53.3 per cent of controls had healed. At the sixth month follow up, 93.3 per cent of cases and 86 per cent of controls had healed.

Conclusion

Healing of the mastoid cavity, as evidenced by epithelialisation and formation of a dry cavity, was faster in cases that received the graft when compared with controls without the graft.

Keywords

Otitis MediaMastoidMastoidectomySkin Grafting
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 135 , Issue 12 , December 2021 , pp. 1094 - 1099
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Dr V K Bhat takes responsibility for the integrity of the content of the paper

Presented at 72nd Annual Conference of the Association of Otolaryngologists of India, 10–12 January 2020, Nagpur, India.

References

Chhapola, S, Matta, I. Mastoid obliteration versus open cavity: a comparative study. Ind J Otolaryngol Head Neck Surg 2014;66:207–1310.1007/s12070-011-0429-xCrossRefGoogle ScholarPubMed
Sade, J, Weinberg, J, Berco, E, Brown, M, Halevy, A. The marsupialized (radical) mastoid. J Laryngol Otol 1982;96:869–7510.1017/S0022215100093221CrossRefGoogle ScholarPubMed
Nadol, JB. Causes of failure of mastoidectomy for chronic otitis media. Laryngoscope 1985;95:410–310.1288/00005537-198504000-00008CrossRefGoogle ScholarPubMed
Rambo, JHT. Musculoplasty: advantages and disadvantages. Ann Otol Rhinol Laryngol 1965;74:535–5410.1177/000348946507400221CrossRefGoogle ScholarPubMed
Youngs, RO. The histopathology of mastoidectomy cavities, with particular reference to persistent disease leading to chronic otorrhoea. Clin Otolaryngol Allied Sci 1992;17:505–1010.1111/j.1365-2273.1992.tb01706.xCrossRefGoogle ScholarPubMed
Henatsch, D, Alsulami, S, Duijvestijn, AM, Cleutjens, JP, Peutz-Kootstra, CJ, Stokroos, RJ. Histopathological and inflammatory features of chronically discharging open mastoid cavities: secondary analysis of a randomized clinical trial. JAMA Otolaryngol Head Neck Surg 2018;144:211–1710.1001/jamaoto.2017.2801CrossRefGoogle ScholarPubMed
Tansuker, HD, Öğreden, Ş, Özyılmaz, C, Cengiz, AB, Beder, ŞE, Oktay, MF et al. Effect of the fascia graft size on healing rate of cavities in patients undergoing CWD tympanomastoidectomy: a clinical prospective study. J Int Adv Otol 2019;15:189–9210.5152/iao.2019.5731CrossRefGoogle ScholarPubMed
Beales, PH, Hynes, W. Rapid healing after mastoid surgery by the use of the post-auricular flap. J Laryngol Otol 1958;72:888–90110.1017/S002221510015875XCrossRefGoogle ScholarPubMed
Guilford, FR, Wright, WK. Secondary skin grafting in fenestration and mastoid cavities. Laryngoscope 1954;64:626–3110.1288/00005537-195407000-00006CrossRefGoogle ScholarPubMed
Cremers, WR, Smeets, JH. Acquired atresia of the external auditory canal: surgical treatment and results. Arch Otolaryngol Head Neck Surg 1993;119:162–410.1001/archotol.1993.01880140044007CrossRefGoogle ScholarPubMed
Takeda, T, Saito, H, Takeuchi, S, Komada, I. Pinch grafting of the open mastoid cavity. Auris Nasus Larynx 1991;18:9–1510.1016/S0385-8146(12)80245-8CrossRefGoogle ScholarPubMed
Walsh, RM, Davies, MM, McGlashan, JA, Bowdler, DA. The role of the Davis graft technique in the treatment of chronic post-mastoidectomy otorrhoea. Clin Otolaryngol Allied Sci 1996;21:162–710.1111/j.1365-2273.1996.tb01323.xCrossRefGoogle ScholarPubMed
Renton, JP, Wetmore, SJ. Split-thickness skin grafting in postmastoidectomy revision and in lateral temporal bone resection. Otolaryngol Head Neck Surg 2006;135:387–9110.1016/j.otohns.2005.10.065CrossRefGoogle ScholarPubMed
Wetmore, SJ, Bueller, HA, Cost, JL. Split thickness skin grafting in canal wall down tympanomastoidectomy. Otol Neurotol 2014;35:97–10010.1097/MAO.0b013e3182a4445dCrossRefGoogle ScholarPubMed
Premachandra, DJ, Woodward, B, Milton, CM, Sergeant, RJ, Fabre, JW. Long term results of mastoid cavities grafted with cultured epithelium prepared from autologous epidermal cells to prevent chronic otorrhea. Laryngoscope 1993;103:1121–510.1288/00005537-199310000-00008CrossRefGoogle ScholarPubMed
Morris, M, Mitchell, C, Snell, S, Sperling, N. Contemporary skin grafting in otologic surgery. Ear Nose Throat J 1992;71:652–410.1177/014556139207101209CrossRefGoogle ScholarPubMed