Article Type

Original Study


Objectives: To investigate the importance of the integrity and pattern of theperiosteal lining of the mastoid cavity in the outcome and sequel of the differenttypes of the mastoid surgeries.Methods:Revision mastoid surgeries (122 cases) of different kinds (bothcanalwall-up and canal wall-down mastoidectomies) between the years2010and 2015 were included. Intra-operative multiple curettages from theunhealthy-lookingbone in direct relation to pathologic findings as granulations,polypi, and cholesteatoma were collected and histopathologicallystudiedto determine the nature of the bony tissue and the status of the periosteum.Preoperative computed tomography (CT) scans for both revisionandprimary surgery for every case were evaluated whenever possible.Results:In all cases, periosteal problems could be detected. Periosteallayerdeficiency in 1 or more areas of the mastoid cavity was present in almostall cases, and it was always replaced by granulation tissue or unhealthybony tissue. Periostitis was suspected in 23 cases (18%), whereasosteitisof different levels of severities was suspected in 69 cases (57%).Scleroticand diploic cellularity types of mastoid were mostly affected. In addition,when the primary surgery was performed in cellular mastoid, thesepathologicfindings were very minimal.Conclusions:Healthy integral periosteal lining of the mastoid cavity seemsto be an essential factor for the cavity stability and surgery outcome. Detailedunderstanding of the mastoid cavity development, anatomy, and histologytogether with the studying of the preoperative CT scans helps in preservingthe integrity of the cavity periosteum during surgery.

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.