Capillary hemangioma  involving external auditory canal, middle ear and mastoid cavity is a very rare entity. Due to infrequent incidence but multiple overlapping clinical and radiological features amongst some common middle ear pathologies this benign vascular tumour often can be misdiagnosed. Histopathological report helps us to get definitive diagnosis. 40 years old female presented with diminished hearing and mass in right ear cavity for last 3 years. The otoscopic examination of right ear showed a pinkish polypoidal mass at the external auditory canal and tympanic membrane could not be visualized. Patient had a history of cortical mastoidectomy 2 years back for the similar problem. HRCT temporal bone revealed a single cavity with soft tissue density content in right mastoid cavity which was extending into right middle ear and external ear. Contrast Enhanced MRI showed a long polypoidal heterogeneously but strong enhancing T2 and STIR hyperintense lesion within mastoid antrum extending into middle ear cavity and external auditory canal forming an aural polyp. Excision of the mass was done by canal wall down mastoidectomy and also type IIIc tympanoplasty performed in same sitting. There is no recurrence noted after 6 months of follow up and hearing improvement noticed. Capillary haemangioma of mastoid antrum extending to middle ear and external auditory canal requires surgical excision as preferred treatment modality, pre-operative imaging guide us to choose the preferred surgical approaches.

To compare the volume of cortical bone dust collected and the time taken for bone dust collection by using a self-devised bone dust collector and that by manual method using a metal scoop in patients undergoing modified radical mastoidectomy with mastoid cavity obliteration. A prospective study was done in 62 patients of cholesteatoma. They underwent canal wall down mastoidectomy. Mastoid cavity was obliteration was done using cortical bone dust collected after dividing the patients randomly into 2 groups: (1) using a collector device made using a mucous extractor fitted with a nylon mesh of size 1″ × 3″ attached to the suction tube, (2) collected manually by using a metal scoop. The time taken for the collection of bone dust was recorded and the volume of bone dust collected was measured and recorded. We found that the time taken for the collection of bone dust was significantly lower and the volume of bone dust collected was higher using a mucous extractor as compared to that by manual collection using a metal scoop. The suction based mucous extractor performed better in terms of both time taken for collection and also in the volume of cortical bone dust that was collected as compared to manual collection using a metal scoop. Therefore, we conclude from our study that using the suction based mucous extractor is a more effective method of cortical bone dust collection for mastoid cavity obliteration.

The article presents modern approaches to mastoid obliteration in cases of chronic purulent otitis media with cholesteatoma, published in peer-reviewed russian and foreign journals from 2017 to 2021. The review tells us about effect of mastoid cavity obliteration on reducing the recurrence of cholesteatoma, improving the quality of life of patients according to the results of international questionnaires and the effect of surgery on hearing in the long-term postoperative period. An analysis of the use of autologous and biocompatible materials in middle ear surgery is presented. Their safety and ease of use during surgical intervention were evaluated.
В статье рассмотрены современные подходы к проведению мастоидопластики у больных хроническим гнойным средним отитом с холестеатомой, описание которых опубликовано в рецензируемых российских и зарубежных журналах в период с 2017 по 2021 г. Представлены исследования, в которых доказаны преимущества облитерации мастоидальной полости с точки зрения уменьшения рецидива холестеатомы, улучшения качества жизни пациентов, а также изучено влияние операции на слух в отдаленном послеоперационном периоде. Проведен анализ использования аутологичных и биосовместимых материалов в хирургии среднего уха. Выполнена оценка их безопасности, а также удобства применения в ходе хирургического вмешательства по данным ведущих отечественных и зарубежных экспертов.

暂无摘要。

OBJECTIVE: To evaluate the surgical results of revision canal wall down (CWD) surgery for chronically discharging mastoid cavities and to compare the non-obliteration approach to mastoid obliteration with canal wall reconstruction.
METHODS: This is a retrospective cohort study. All adult patients (≥ 18 years) who underwent revision surgery for chronically draining mastoid cavities between January 2013 and January 2020 were included. Primary outcome measures included the dry ear rate, complications and postoperative hearing.
RESULTS: 79 ears were included; 56 ears received revision CWD with mastoid obliteration and posterior canal wall reconstruction and 23 ears received CWD without mastoid obliteration. The dry ear rate at the most recent outpatient clinic visit (median 28.0 months postoperative) was significantly higher in the obliteration group with 96.4% compared to 73.9% for the non-obliteration group (p = .002). There were no differences in audiological outcome and incidence of complications between the two techniques.
CONCLUSIONS: We show that in our study population revision CWD surgery with mastoid obliteration and posterior canal wall reconstruction is superior to revision CWD surgery without mastoid obliteration in the management of chronically discharging mastoid cavities. In the obliteration group, a dry ear was achieved in 96.4% as this was 73.9% in the non-obliteration group. We found no differences in audiological outcome and in incidence of complications between the two techniques.

UNASSIGNED: Acute neurological sequela in patients with COVID-19 infection include acute thromboembolic infarcts related to cytokine storm and post infectious immune activation resulting in a prothrombotic state. Radiologic imaging studies of the sinonasal tract and mastoid cavity in patients with COVID-19 infection are sparse and limited to case series. In this report, we investigate the radiologic involvement of nasal cavity, nasopharynx, paranasal sinuses, and mastoid cavity in patients with SARS-CoV-2 infection who presented with acute neurological symptoms.
UNASSIGNED: Retrospective review of medical records and neuroradiologic imaging in patients diagnosed with acute COVID-19 infection who presented with acute neurological symptoms to assess radiologic prevalence of sinus and mastoid disease and its correlation to upper respiratory tract symptoms.
UNASSIGNED: Of the 55 patients, 23 (42%) had partial sinus opacification, with no evidence for complete sinus opacification. The ethmoid sinus was the most commonly affected (16/55 or 29%). An air fluid level was noted in 6/55 (11%) patients, most commonly in the maxillary sinus. Olfactory recess and mastoid opacification were uncommon. There was no evidence of bony destruction in any of the studies, Cough, nasal congestion, rhinorrhea, and sore throat were not significantly associated with any radiological findings.
UNASSIGNED: In patients who present with acute neurological symptoms, COVID-19 infection is characterized by limited and mild mucosal disease within the sinuses, nasopharynx and mastoid cavity.
UNASSIGNED: 4.

OBJECTIVE: Different types of chronic middle ear disease (CMED) present with differing severity of single symptoms, such as discharge, vertigo or hearing loss, which impair health-related quality of life (HRQoL). Here, we aimed to (i) investigate characteristics of HRQoL and (ii) evaluate the association between HRQoL and hearing among different types of CMED.
METHODS: In this prospective longitudinal cohort study, we included adult patients undergoing surgical treatment for CMED. Primary outcomes included HRQoL assessed by the Zurich Chronic Middle Ear Inventory (ZCMEI-21) and hearing assessed by pure-tone audiometry.
RESULTS: In the included 108 patients (51% females), CMED were chronic otitis media (COM) with (n = 46) or without (n = 22) cholesteatoma, persistent mastoid cavity (with [n = 15] or without [n = 10] recurrent cholesteatoma), revision ossiculoplasty for hearing restoration (n = 14), and postinflammatory meatal fibrosis (n = 1). Preoperatively, the mean ZCMEI-21 score showed statistically significant differences among different types of CMED (p = 0.007) with persistent mastoid cavity without cholesteatoma exhibiting the highest score (34.1, SD 7.7) indicating poor HRQoL. At a mean follow-up period of 183 days, no statistically significant differences in the ZCMEI-21 scores among different types of CMED were observed (p = 0.67).
CONCLUSIONS: This study objectifies differences in HRQoL among different types of CMED. In patients with indication for functional surgery only, e.g., persistent mastoid cavity without cholesteatoma, the worst HRQoL was observed. Yet, in these types of CMED, HRQoL guides decision for treatment. Moreover, differences in HRQoL among different types of CMED were not closely associated with hearing, but largely depended on other symptoms, such as discharge or vertigo.

暂无摘要。

OBJECTIVE: Cartilage is a rigid material that is highly resistant to infection and retraction and is tolerated well by the middle ear. The purpose of this study was to review retrospectively the results of cases of mastoid cavity obliteration with cartilage performed after canal wall down (CWD) mastoidectomy and to discuss the literature.
METHODS: Of 983 patients who underwent surgery for chronic otitis media between January 2000 and June 2012, 54 patients who underwent CWD mastoidectomy plus mastoid cavity obliteration with cartilage and who were followed up regularly were selected from the database and invited for re-evaluation. All patients who came for a follow up after the invitation were examined and their data were evaluated retrospectively.
RESULTS: Thirty-five of the patients who accepted the invitation were included in the study. All of the patients in the study underwent mastoid cavity obliteration with conchal and/or tragal cartilage grafts. The duration of follow up ranged from 21 to 41 months (average, 27.3 months). Epithelization occurred in all patients with dry cavity, except one who had residual cholesteatoma and underwent revision surgery.
CONCLUSIONS: The results of this study indicate that cartilage can be preferred for obliteration of mastoid cavity after CWD mastoidectomy.
UNASSIGNED: Kartilaj enfeksiyon ve retraksiyona karşı oldukça dirençli ve orta kulak tarafından iyi tolere edilen sert bir malzemedir. Bu çalışmanın amacı, canal wall down (CWD) mastoidektomi sonrası kartilaj ile mastoid kavite obliterasyon yapılan olguların sonuçlarını geriye dönük olarak gözden geçirmek ve literatürü tartışmaktır.
UNASSIGNED: Ocak 2000 - Haziran 2012 tarihleri arasında kronik otitis media ameliyatı geçirmiş 983 hastadan, CWD mastoidektomi ve mastoid kavite obliterasyonu yapılan ve düzenli aralıklarla takip edilen 54 hasta veri tabanından seçildi ve yeniden değerlendirme için çağrıldı. Tekrar inceleme için gelen tüm hastalar değerlendirilerek verileri retrospektif olarak analiz edildi.
UNASSIGNED: Yeniden değerlendirme için çağırılan hastaların 35’i çalışmaya dahil edildi. Çalışmaya alınan tüm hastalara konkal ve/veya tragal kartilaj greftler ile mastoid kavite obliterasyonu uygulandı. Takip süresi 21 ila 41 ay arasında değişmekte idi (ortalama, 27.3 ay). Rezidüel kolesteatom gelişen ve revizyon ameliyatı geçirilenlerin haricinde kuru kaviteli tüm hastalarda epitelizasyon görüldü.
UNASSIGNED: Bu çalışmadan elde edilen sonuçlar, CWD mastoidektomi sonrası mastoid kavite obliterasyonu için kartilaj tercih edilebileceğini göstermektedir.

OBJECTIVE: To assess the change in health-related quality of life (HRQoL) in patients undergoing mastoid cavity obliteration.
METHODS: Patients who had undergone canal wall-down mastoidectomy for chronic otitis media with creation of a persistent mastoid cavity and underwent revision tympanomastoid surgery including mastoid cavity obliteration using autologous material were included. Audiological measurements including air conduction (AC) and bone conduction (BC) pure-tone averages (PTA) and the air-bone gap (ABG) were assessed. Health-related Quality of Life (HRQoL) was assessed by the Zurich Chronic Middle Ear Inventory (ZCMEI-21) pre- and postoperatively.
RESULTS: A total of 25 patients (16 females and 9 males; mean age 51.6 years, 14 right and 11 left ears) were included. Patients were reexamined after a mean follow-up period of 9.2 months (SD = 6.5) after obliteration of the mastoid cavity. Compared to the preoperative visit, patients showed a significantly reduced AC PTA at the postoperative visit (mean difference: - 4.1; SD = 10.4, p = 0.045). The mean ZCMEI-21 score changed from 31.7 (SD = 14.5) preoperatively to 17.4 (SD = 15.1) postoperatively (mean difference: - 14.3; SD = 19.1; p = 0.0002). The mean ZCMEI-21 score changes were neither correlated to the AC PTA shift (p = 0.60) nor to the ABG shift (p = 0.66).
CONCLUSIONS: This is the first study reporting a highly significant and clinically important improvement in HRQoL after mastoid cavity obliteration in a prospective setting. The improvement in HRQoL was not correlated to the hearing improvement. As a clinical implication, we provide evidence for a substantial subjective benefit of the surgical obliteration of a symptomatic mastoid cavity and, therefore, encourage this surgical procedure.