Surgical management of troublesome mastoid cavities.

Objective: To examine the reasons for discharging mastoid cavities, the operative findings during revision surgery, and the medium-term outcome.

Patients: One hundred and forty revision mastoidectomies in 131 patients were studied. Post-operatively, patients were followed up at three, six and 12 months and then yearly.

Intervention: A variety of techniques were performed. Over 80 per cent of ears were treated with mastoid obliteration. Concomitant hearing restorative procedures were carried out in one-third of the ears.

Results: The mastoid cavities were troublesome because of large cavity size, bony overhang, residual infected mastoid cells, the presence of cholesteatoma or perforations, and/or inadequate meatoplasty. One year after revision mastoidectomy, over 95 per cent of the ears had become completely 'dry' and water-resistant. Overall, 50.9 per cent of the ears had a 12-month post-operative air-bone gap of 20 dB or less.

Conclusion: Revision mastoidectomy has a high success rate in converting troublesome mastoid cavities into dry, water-resistant ears.