Hearing outcomes in canal wall up versus canal wall down mastoidectomy

Bhardwaj Y, Bhardwaj H, Amin S, Mahmood T

Pdf Page Numbers :- 258-262

Yavan Bhardwaj¹, Heemani Bhardwaj^2,3*, Saddaf Amin³ and Tariq Mahmood³

¹Department of ENT, Dr. Ram Manohar Lohia Hospital, New Delhi, Delhi 110001, India

²Department of ENT, Hindu Rao Hospital, Gandhi Square, Malka Ganj, Delhi 110007, India

³Department of ENT, Government Medical College and Hospital, Bakshi Nagar, Jammu, Jammu and Kashmir 180016

*Corresponding author: Dr. Heemani Bhardwaj, M.S ENT, Senior Resident, Department of ENT, Hindu Rao Hospital, Gandhi Square, Malka Ganj, Delhi 110007, India. Email: dr.heemanibhardwaj@gmail.com

Received 28 February 2025; Revised 30 May 2025; Accepted 11 June 2025; Published 20 June 2025

Citation: Bhardwaj Y, Bhardwaj H, Amin S, Mahmood T. Hearing outcomes in canal wall up versus canal wall down mastoidectomy. J Med Sci Res. 2025; 13(3):258-262. DOI: http://dx.doi.org/10.17727/JMSR.2025/13-45

Copyright: © 2025 Bhardwaj Y et al. Published by KIMS Foundation and Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

Introduction: Chronic suppurative otitis media (CSOM) is a common condition with significant morbidity and psychosocial impact. Surgical management, primarily canal wall up or canal wall down mastoidectomy, is chosen based on surgeon preference, patient factors, disease extent, and hearing outcomes. The aim of the present study was to compare the hearing outcomes and graft take up rate between canal wall up and canal wall down mastoidectomy procedures.

Methods: The present prospective study was conducted in the Department of Otorhinolaryngology and Head Neck Surgery, a tertiary care multi-speciality teaching hospital from October 2020 to August 2022. The study group included 100 patients. In this study, all the patients underwent mastoidectomy with tympanoplasty using temporalis fascia graft. Intact canal wall mastoidectomy was done in patients with localized cholesteatoma while canal wall down mastoidectomy was done in patients having extensive disease. Regular follow up was done every week for first 3 weeks, later at 6th week, 3rd month, 6th month and 1 year.

Results: A total of 100 patients were included in the study. The age of the patients 10 to 50 years with a mean age of 18.7±15 years with male to female ratio 7:10. In the present study, graft take up in canal wall up mastoidectomy was 66.6% as compared to 33.4% in canal wall down procedure which was significantly higher (ꭓ2=10.72, p= 0.0011). Hearing gain in canal wall up procedure (17.02±8.51db) was higher as compared to canal wall down mastoidectomy (10.3±6.98), (t= 4.22, p <0.001). It was statistically significant. Recurrence was seen in 1 patient who had undergone canal wall up surgery.

Conclusions: Canal wall down mastoidectomy is a safer option in the matter of residual disease and recurrence. Canal wall up surgery though may need a second look procedure, but there are better results of graft take up rate and the post-operative hearing as compared to canal wall down procedure

Keywords: chronic suppurative otitis media, hearing, canal wall up mastoidectomy, canal wall down mastoidectomy.