Mastoid Obliteration versus Open Cavity Technique in Radical Mastoidectomy Procedures in Pediatric Population: A Comparative Study

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Abstract Background: Cholesteatoma is a common medical condition affecting the younger population. It is a medical challenge for management and therapy since it is more widespread and expansile and has a high recurrence rate. The primary method of managing cholesteatoma is surgery, usually using an open or closed cavity technique. This surgery aims to completely eradicate bone and epithelial disease, stop recurrence, create a dry, safe ear, and regain functional hearing. Open cavities are frequently used to remove cholesteatoma in children because they are easier to monitor and carry a lower risk of recurrence. Nevertheless, there are no disadvantages to these operations. Surgeons worldwide are familiar with the symptoms of open cavities, which include deformity, hearing, discharge, disorientation, and debris. To lessen the detrimental effects of the open cavity approach on patients, mastoid obliteration has recently been employed. The study objectives are to assess the impact of this technique on the outcomes of open cavity mastoidectomy in the pediatric population. Patients and Methods: This was a prospective comparative cohort study. For the study, 40 children were enlisted and divided into two groups. The first had a radical mastoidectomy (RM) by itself, while the second had an RM using the obliteration procedure. Results: As regards discharge (10% vs. 100%; P < 0.001) and pain (70% vs. 10%; P < 0.001), patients who had mastoid obliteration significantly improved after surgery compared to those who had RM alone. Regarding hearing loss, the mean postoperative pure-tone average in the obliteration group (21.5 dB) was better than that in the nonobliteration group (28.5 dB). Tinnitus (20% vs. 40%; P = 0.15) showed negligible variations between the groups. All patients with preoperative vertigo reported complete resolution. Aural granulation and wax formation were recorded by 12 (60%) and 16 (80%) patients who received RM alone, respectively, but not by any of the patients who underwent mastoid obliteration. Conclusion: Mastoid obliteration after RM improves hearing and reduces chronic cavity issues in pediatric patients. It ought to be regarded as the best course of action, particularly for kids who are more susceptible to recurrence and less tolerant of cavity cleaning.