Retrospective and Prospective Study of Singapore Swing Method on Healing of Mastoid Cavity

Chronic suppurative otitis media with cholesteatoma is a common problem. The majority of ENT surgeons find the canal wall down operation to be the safest and simplest means of treating cholesteatoma. The 'Singapore Swing' is a method of promoting healing of mastoid cavity. In this study our main objective was to do Singapore Swing technique in larger number of cases, have long term follow-up and to compare its results with other mastoid operations in which obliteration has not been used. Patients of cholesteatoma were divided into case group and control group. The case group (26 patients) was operated by canal wall down procedure with Singapore Swing obliteration while the control group (62 patients) was operated by same method without any obliteration. Both retrospective and prospective studies were done. Time period of drying of mastoid cavity, numbers of visits to the hospital and hearing status were observed. Subjective satisfaction score of patient (0-10) and Surgeon's satisfaction score (fully satisfied, partially satisfied and not satisfied at all) were measured in both the groups. The time of drying of cavity was < 2 months in 88.5% of cases, while 27.5% of controls. Mean time of drying of cavity was 46 days (1A1/2A months) in case group, while it was 89 days (3 months) in control group. Gain in air conduction was 11-30 dB in 33.3% cases and 15.7% of controls. 2 patients in control group had deterioration of 1-10 dB in air conduction. Subjective satisfaction score was 8-10 in 42.4% patients in case group, while 25% in control group. Surgeon was fully satisfied in 73% patients of case group and 45% patients of control group. The study suggested that Singapore Swing technique provides a dry, small and stable cavity with better hearing in less time.