Causes of Failure of Canal Wall down Mastoidectomy

Aims: To identify the causes of failure of the canal wall down mastoidectomy and evaluate the causes for discharging mastoid cavity and to address the causes of failure of previous surgery to minimize the Revision surgery. Materials and methods: This was a prospective and retrospective observational study conducted at a tertiary care hospital from May 2019 to December 2021. Total 20 Patients (11 male & 9 female) with age group (0-60 years) who previously underwent canal wall down mastoidectomy and presented with complaints of persistent ear discharge were included. All patients underwent otoscopic, oto-endoscopic and microscopic examination. Results: Out of 20 cases,13 cases had residual/recurrent cholesteatoma, 11 cases had narrow meatoplasty and 9 cases had high facial ridge.Other causes for failure are graft defect, incomplete removal of anterior and posterior buttress. Conclusion: Recurrent/residual cholesteatoma and Narrow meatoplasty are most common cause for failure of previous surgery. Persistent granulation at un-exenterated area was the most common cause for suppuration. Regular follow up and cleaning of the debris from cavity enhances the epithelialization and healing of the cavity.