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In this study, the authors retrospectively compare hearing outcomes after mastoid obliteration to non-obliterative techniques in cholesteatoma surgery. They have performed canal wall up with mastoid obliteration (bony obliteration tympanoplasty or BOT) since 2013. The procedure has replaced canal wall up (CWU) and canal wall down (CWD) approaches without mastoid obliteration at their institution. Their study did not find any significant difference in the postoperative air bone gap between the BOT and the non-obliteration CWU and CWD techniques. The authors report that obliteration of the mastoid and epitympanic space in cholesteatoma surgery has promising outcomes and is gaining popularity. Their rationale for this is that it reduces mucosal surface for gas exchange and, therefore, can improve gas pressure balance in the middle ear resulting in slower gas absorption and slower pressure changes. As a result, mastoid obliteration facilitates better aeration of the middle ear.

A retrospective analysis of hearing after cholesteatoma surgery: the bony obliteration tympanoplasty versus canal wall up and canal wall down without mastoid obliteration.
van der Toom HFE, van der Schroeff MP, Metselaar M, et al.
2022; Online ahead of print.
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Gauri Mankekar

Department of Otolaryngology-Head Neck Surgery, Louisiana State University Shreveport, Louisiana, USA.

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