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KMID : 0361020010440010026
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Korean Journal of Otolaryngology - Head and Neck Surgery
2001 Volume.44 No. 1 p.26 ~ p.31
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Mastoid Obliteration with Bone Paste and Fat
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이원상/Won Sang Lee
최재영/양해동/조창현/김인섭/Jae Young Choi/Hae Dong Yang/Chang Hyun Cho/In Sup Kim
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Abstract
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Background and Objectives : Mastoidectomy with canal wall-up technique provides more healthy skin lining conditions of the external ear canal than mastoidectomy with canal wall-down techniques which have several disadvantages. However, in
patients
who
have erosive scutum or posterior wall defects, the canal-wall down procedure is selected for preventing retraction pocket and recurrence of cholesteatoma. We have attempted a new surgical procedure to avoid disadvantages of the canal wall-down
procedure
in patients with scutum or posterior wall defects. Materials and Methods : In 84 patients with chronic otitis media whose scutum or posterior walls have defects, we advocated a new surgical procedure. The posterior wall kept up, the defected
scutum
and/or posterior wall was reconstructed with cortical bone paste, and the mastoid cavity was obliterated with abdominal fat. Staged ossiculoplasty was performed for 11 patients. Results : Removal of the bone paste was necessary for only one
patient
due
to infection, but none of the patents had absorption of reconstructed posterior canal wall. In most patients, the wound completely healed within 3 weeks. The mean hearing gain was 21 dB after the staged ossiculoplasty. Conclusion : With this
procedure,
we could avoid disadvantages of the canal wall-down procedure. And in staged ossiculoplasty we found enough middle ear space for ossicle reconstruction.
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KEYWORD
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