Anwar-ul Haq, Muhammad Khan, Asif Alam Gul, Adnan Asghar.
Cholesteatoma wall – a useful lining for healthy mastoid cavity.
Pak Armed Forces Med J Jan ;70(3):787-91.

Objective: To evaluate the usefulness of residual cholesteatoma wall as a lining of mastoid cavity in achieving a dry mastoid cavity after a canal wall down (CWD) mastoidectomy. Study Design: Experimental study. Place and Duration of Study: Combined Military Hospital Lahore, from May 2015 to Oct 2016. Methodology: Both adults and children (58 cases) undergoing canal wall down mastoidectomies were included in the study. While removing the cholesteatoma, medial wall of fundus was left intact and wide opening was ensured to leave it saucer shaped. Post operatively all patients were observed to see that when their mastoid cavities become dry and asymptomatic. Results: Out of total 58 patients operated 11 were children and 47 adults. Age range was 11 to 67 years. Thirty patients were males and 28 were females. Following Canal Wall Down mastoidectomies all the mastoid cavities were managed regularly and at the end of four months 27 (47%) cavities became dry. At six months 49 (84%) became dry and one was still wet after one year of surgery. Conclusion: At 12 month follow up, 98% percent of mastoid cavities were dry and asymptomatic with our technique of leaving part of cholesteatoma wall. However longer follow-up and larger sample is required for better outcome assessment.

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