Simple Mastoidectomy with Air Chamber Creation in Progressive Adhesive Otitis

Abstract

The writer treated 87 ears in the progressive stage of adhesive otitis with simple mastoidectomy and air chamber creation. The idea was, first, to cure the latent mastoiditis present at this stage of the disease and, second, to create a large air space connected with the tympanum. During the operation, performed via the postauricular approach, the granulations, with their secretion-producing glandlike areas, and all soft bone and fluid were removed. The final result was an operative cavity with smooth, hard walls. The aditus ad antrum was enlarged slightly to create a communication between the operative cavity and the tympanum. The large, air-filled cavity connected with the middle ear facilitates the functioning of the eustachian tube. Pure-tone audiograms taken preoperatively and an average of 8.3 months after the operation reveal that both the air and the bone conduction curves had in most cases improved. The values are calculated as averages for 500, 1000 and 2000 cps. No improvement in hearing was achieved by this operation alone at the terminal stage of the disease. The etiology and pathogenesis of adhesive otitis are discussed.