Abstract
A panel discussion on the mastoid obliteration technique was held at the 12th Annual Meeting of the Otological Society of Japan in Tokyo, and its feature articles were published in Otology Japan: Vol.13, No 1, 2003.
The panelists all agreed for the present to do the mastoid obliteration, although some of them expressed that it is a necessary evil, or it should disappear in the future, and also there is no evidence to judge the repneumatization of the mastoid cavity before and during the surgery.
In the 1970's, the intact canal wall tympanoplasty combined with mastoidectomy was done in many cases of chronic otitis media and cholesteatoma. And there occurred ca. 50% of re-retraction in the cases of cholesteatoma, and nothing of retraction in the cases of otitis media. This clinical fact is the evidence that there must be an anatomical difference between the both diseased ears. By the temporal bone studies, the difference was made clear that a ventilatory route via the supratubal recess exist in the otitis ear, and not in the cholesteatoma ear. By making the ventilatory route via the supratubal recess (anterior tympanotomy), the re-retraction has decreased significantly without the obliteration procedure in the cholesteatoma ears operated on with intact canal wall technique.
To heal the cholesteatoma physiologically without the obliteration technique, remodeling of the supratubal recess area is absolutely needed.
