Impact of single-pedicle muscle flap with bone pate on vestibular function after mastoid obliteration / 中国耳鼻咽喉头颈外科

ABSTRACT

OBJECTIVE To evaluate the impact of mastoid obliteration withsingle-pedicle muscle flap covered by bone pate on vestibular stimulation. METHODS A retrospective study was performed on 59 patients who were treated for chronic otitis media with or without cholesteatoma by two techniques: canal wall down tympano-mastoidectomy(CWD) and subsequent mastoid obliteration(MO). The postoperative vestibular functions of all the patients in both groups were assessed by vestibular function tests and questionnaires. Finally, the data of examination a nd symptoms were a nalyzed. RESULTS After a minimum follow up period of 12 months, the rate of ear dry was 84％(22/26) for MO group and 55％(18/33) for CWD group(χ2=4.72, P <0.05). The dry ear time were 5.46±1.39 weeks for MO group and 8.67±2.3 weeks for CWD group(t =6.2529, P <0.05). When compared latent period of Caloric testing in the MO group (10.3±2.57)s and CWD group (12.7±3.33)s, significant differencewas found(t =3.1639, P <0.05). The postoperative caloric vestibular tests revealed an average nystagmus count of 52.96±20.82 beats per minute in the MO group and 69.94±18.98 beats in the CWD group(t =3.2688, P <0.05). By analyzing the questionnaire, 30％(10/33) of the patients who received CWD treatment reported vertigo by caloric stimuli such as wind, water compared with MO group(0)(χ2=7.45, P <0.05). The rate of suction cleaning induced vertigo was 48％(16/33) in CWD group and 23％(6/26) in MO group(χ2=3.17, P =0.075). CONCLUSION Our technique of mastoid obliteration with single-pedicle muscle flap covered by bone pate results in small cavities with complete epithelialization of all surfaces. Furthermore, obliteration of mastoid cavities provides protection to the labyrinthine organ and reduces postoperative vertigo to caloric stimulation.