Comparison of Efficacy of Canal Wall up Mastoidectomy with Canal Wall Down Mastoidectomy in Surgical Management of Otitis Media with Cholesteatoma
Objectives: To compare the efficacy of Canal Wall Up (CWU) Mastoidectomy with Canal Wall Down (CWD) Mastoidectomy in the surgical management of chronic otitis media with cholesteatoma in local population. Patients and Methods: A total of sixty patients with chronic otitis media, cholesteatoma and granulation tissue were enrolled. Patients were randomly divided into two groups; Group A patients underwent CWU Mastoidectomy while Group B patients underwent CWD Mastoidectomy. Both groups were followed for 6 months, for recurrence of the disease and associated complications. Chi-square test was applied as a test of significance, to compare the outcomes of CWU Mastoidectomy and CWD Mastoidectomy. a p-value <0.05 was considered as statistically significant Results: Disease recurrence rate was significantly higher in group A (CWU) while complications rates were higher in group B (CWD) patients. Persistent discharge, conductive deafness, and development of mastoid cutaneous fistula were reportedly higher in group B patients (P<0.05).
Conclusion: CWD operations have a higher probability of permanently curing the patient of the cholesteatoma but with higher rates of post-surgical complications. CWU procedures have the advantage of maintaining a near normal anatomy but with a higher risk of residual or recurrent cholesteatomas. Choice of a particular surgical procedure depends on the preference of the surgeon, the nature, and extent of the pathology and the general health of the patient
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