Subtotal Petrosectomy, Cavity Obliteration, and Blind Sac Closure of the External Auditory Canal: Retrospective Analysis of a Series Including 44 Cases

Introduction The procedure of subtotal petrosectomy, cavity obliteration, and blind sac closure of the external auditory canal is an important otologic surgical intervention that can be performed, especially for the patients with little cochlear reserve (1). This operation was first described by the American otologist Rambo in 1958 and has been modified by many authors up to now (2). In this procedure, after all cells are opened and the epithelium and mucosa are cleaned, the external auditory canal is sutured as a “cul de sac” (blind sac), and the current mastoid cavity is completely isolated from the outer environment. During the first years of this operation, the main indication of the operation was to provide ears that do not have any problems by recovering the mastoid cavities with uncontrolled otorrhea, which impairs the quality of life seriously. The fact that this method overlooked the hearing function made the scope of implementation limited to only the ears with unserviceable hearing. However, hearing loss in these patients is rehabilitated with various approaches, particularly with cochlear implantation. Similarly, the applications of an implanted hearing aid and active middle ear plant can offer correction of conductive and mixed-type hearing losses (3, 4). These advantages have repopularized the procedure of “blind sac closure,” especially in patients with cavity problems or with unavoidable ear infection despite multiple operations. The procedure of blind sac closure helps to not only control infection but also protect the cochlear or middle ear implant electrode by cutting off the relationship of the mastoid cavity with the outer environment (5). This has expanded the indications of the surgery and encouraged otologists to perform this operation more comfortably and more frequently. As in all otologic interventions, this surgical intervention also contains general and specific complications intraoperatively and postoperatively (5). In our study, we aimed to share our experiences in subtotal petrosectomy and cavity obliteration surgery that we performed in our clinic and our opinions in light of recently published articles on this topic. Methods Ethics committee approval for this study was received from the ethics committee of Bozyaka Teaching and Research Hospital (2014-94). The files of 44 patients who underwent subtotal petrosectomy operation between January 2009 and 81