Second Stage Reconstruction After Canal Wall Down Mastoidectomy

Objective: To study results of revision surgery with reconstruction of the posterior canal wall and middle ear after canal wall down mastoidectomy using autograft cortical bone. Materials and Methods: This study was conducted on 22 patients with previous canal wall down mastoidectomy. Reconstruction of the posterior canal wall together with reconstruction of the tympanic membrane and ossicular chain were done as a second stage operation. All operations were done at ORL department, Mansoura University hospital, between 2003-2007. Results: Successful reconstruction of the posterior canal wall was achieved in 20 patients. Intact tympanic membrane was obtained in 18 patients. There was significant improvement of hearing after revision surgery. Postoperative complications included, persistent otorrhea in 6 cases, necrosis of the reconstructed canal wall in 2 cases and residual tympanic membrane perforation in 4 cases. Conclusion: Revision surgery with second stage reconstruction of the posterior canal wall and middle ear provides good and stable results as well as improvement of hearing.