MODIFIED RADICAL MASTOIDECTOMY: TECHNIQUES TO DECREASE FAILURE

The aims of surgical treatment for cholesteatoma include complete removal of disease and formation of a dry, self cleaning ear in addition to hearing reconstruction. This presentation concentrates on techniques of open mastoid surgery or modified radical mastoidectomy to achieve a well-constructed cavity. This study analyzes both primary and revision mastoid surgery referred to the author. All patients presented with otorrhea, and four patients presented with facial paralysis, two with labyrinthine and one with oval window fistula. Sclerotic mastoid with extensive cholesteatoma were indications for modified radical mastoidectomy as the treatment of choice. The main method of hearing reconstruction in an open cavity with a mobile stapes was type III tympanoplasty, leading to an improvement in the average air bone gap following surgery in both primary and revision groups. The major causes of failure that were found when revising mastoid cavities were incomplete removal of air cell tracts and inadequate mastoid cavity formation without a sufficient meatoplasty. The techniques of open mastoid or modified radical mastoidectomy that are required to avoid failure are discussed.