MODIFIED CANAL WALL-UP MASTOIDECTOMY WITH MASTOID OBLITERATION FOR SEVERE CHRONIC OTITIS-MEDIA

Mastoid tympanoplasty with a canal wall-up technique provides better c onditions for a healthy skin lining than canal wall-down techniques. T he formation of retraction pockets in residual pneumatized cavities is however a major cause of cholesteatoma recurrence with canal wall-up techniques. We have therefore attempted to combine the advantages of b oth canal wall-down and canal wall-up techniques. The posterior wall i s kept up, the mastoid is obliterated with adipose tissue, the attic i s exteriorized in the ear canal and hearing is restored with a minimal -size hypotympanic cavity only. Preliminary results from 41 cases with a follow-up of 6 months to 6 years suggest that skin conditions in th e enlarged ear canal are adequate and that cholesteatoma do not recur.