Clinical Review of Chronic Otitis Media in Patients with Contracted Mastoid

Lee, Chang Min; Lee, Kyu Yup; Sohn, Jung Ho; Choi, Young Jun; Jang, Hyun Uk; Kim, Jae Hyuk; Lee, Sang Heun

Abstract

BACKGROUND AND OBJECTIVES
High resolution computed tomography (HRCT) helps locating the anatomical structure within the temporal bone preoperatively. Contracted mastoid has lots of changed anatomical structure and outside in technique tympanomastoidectomy procedure cannot provide safe and effective access. The aims of this study are to analyze changed anatomical structure and to suggest safer and more effective surgical procedures in chronic otitis media patients with contracted mastoid. SUBJECTS AND METHOD: We measured distances between important surgical landmarks and cross sectional area of pneumatized air cells in contracted mastoid, and compared with normal groups. We analyzed postoperative complications between outside in technique and inside out technique tympanomastoidectomy. RESULTS: The shortest distance between the posterior wall of external auditory canal and the anterior edge of the sigmoid sinus, the vertical shortest distance between the superior wall of external auditory canal and the tegmen, and the cross-sectional area of mastoid air cells were significantly small in contracted mastoid group (p<0.05). There were 2 cases of postoperative facial weakness by outside in technique tympanomastoidectomy. CONCLUSION: Contracted mastoid has lots of changed anatomical structure. We suggest that inside out technique tympanomastoidectomy procedure is safer and more effective in patients with contracted mastoid.