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<p>Canal Wall Down (CWD) Mastoidectomy is the accepted surgical standard for chronic otitis media (COM) squamous type of disease, offering superior disease eradication at the cost of an open mastoid cavity often associated with prolonged healing, recurrent discharge, water restrictions and lifelong cavity maintenance requirements. Mastoid cavity obliteration using temporalis muscle flap has been proposed to mitigate these complications; however, high quality randomized evidence remains limited. This study is aimed to prospectively compare mastoid cavity obliteration using a pedicled temporalis muscle flap versus conventional non-obliteration following CWD mastoidectomy.&#xa0;This prospective, randomized controlled trial included 58 patients with chronic otitis media squamosal type who underwent CWD mastoidectomy at Department of ENT at a teaching hospital. Patients were randomized into two groups using computer-generated block randomization with sealed opaque envelope allocation concealment.&#xa0;Both groups were comparable in age (Group A: 22.1 ± 10.2 years vs. Group B: 24.2 ± 10.4 years, <i>p</i> = 0.467). Mean ABG closure was 8.87 ± 8.15 dB in Group A and 6.40 ± 5.32 dB in Group B (Welch’s t test = 1.357, <i>p</i> = 0.181). Cavity healing demonstrated significant within-group improvement from 1 to 6 months in both groups (McNemar’s test, <i>p</i> &lt; 0.001 for both). By 6 months, cavity dryness rates were comparable (92.9% vs. 80%, <i>p</i> = 0.256).&#xa0;Mastoid cavity obliteration with temporalis muscle flap and conventional non-obliteration following CWD mastoidectomy are both safe and effective strategies yielding comparable audiometric outcomes and final cavity healing rates at six months. Obliteration demonstrated a clinically meaningful trend toward faster cavity healing and improved water exposure tolerance, while non-obliteration patients showed greater dependence on professional cavity cleaning.</p>

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Evaluating Mastoid Cavity Obliteration Versus Non-Obliteration in Canal Wall Down Procedures: Impact On Recurrence, Hearing and Quality of Life

  • 期刊论文

  • 发表日期：

    2026年6月22日

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  • Aditya Singhal,
  • Pooja Agrawal,
  • Satguru Saran Singh,
  • Abhinav Srivastava,
  • Rupanshi Agarwal,
  • Sumit Agarwal

摘要

Canal Wall Down (CWD) Mastoidectomy is the accepted surgical standard for chronic otitis media (COM) squamous type of disease, offering superior disease eradication at the cost of an open mastoid cavity often associated with prolonged healing, recurrent discharge, water restrictions and lifelong cavity maintenance requirements. Mastoid cavity obliteration using temporalis muscle flap has been proposed to mitigate these complications; however, high quality randomized evidence remains limited. This study is aimed to prospectively compare mastoid cavity obliteration using a pedicled temporalis muscle flap versus conventional non-obliteration following CWD mastoidectomy. This prospective, randomized controlled trial included 58 patients with chronic otitis media squamosal type who underwent CWD mastoidectomy at Department of ENT at a teaching hospital. Patients were randomized into two groups using computer-generated block randomization with sealed opaque envelope allocation concealment. Both groups were comparable in age (Group A: 22.1 ± 10.2 years vs. Group B: 24.2 ± 10.4 years, p = 0.467). Mean ABG closure was 8.87 ± 8.15 dB in Group A and 6.40 ± 5.32 dB in Group B (Welch’s t test = 1.357, p = 0.181). Cavity healing demonstrated significant within-group improvement from 1 to 6 months in both groups (McNemar’s test, p < 0.001 for both). By 6 months, cavity dryness rates were comparable (92.9% vs. 80%, p = 0.256). Mastoid cavity obliteration with temporalis muscle flap and conventional non-obliteration following CWD mastoidectomy are both safe and effective strategies yielding comparable audiometric outcomes and final cavity healing rates at six months. Obliteration demonstrated a clinically meaningful trend toward faster cavity healing and improved water exposure tolerance, while non-obliteration patients showed greater dependence on professional cavity cleaning.