Mohammad Faramarzi, Amirhossein Babaei, Ali Faramarzi, Hamed Sajjadi
The Journal of International Advanced Otology - 2026;22(2):1701-1708
BACKGROUND: Mastoid obliteration after canal wall down mastoidectomy (CWDM) is recommended to reduce both complications and recurrence. In this study, the bone allograft was used for mastoid obliteration in large cavities and reconstruction of the external auditory canal (EAC) after retrograde CWDM. METHODS: This is a prospective, single-arm, open-label trial. Inclusion criteria were adult patients (>18 years old) who had undergone retrograde CWDM due to chronic otitis media with cholesteatoma. Bone allograft was used for mastoid obliteration in large cavities and for EAC reconstruction. RESULTS: Ninety patients completed the study. Granulation tissue developed in 27 (30%) patients; it was mild and was managed by applying 5% trichloroacetic acid in 24 patients. Three patients underwent revision surgery due to severe granulation tissue formation. Otorrhea was observed in all 27 patients with granulation tissue (30%), but it was stopped after the application of trichloroacetic acid in 24 patients. Persistent otorrhea was reported only in 3 patients with severe granulation tissue formation. In 87 patients (96.67%), epithelialization of the mastoid cavity was completed after 2 months of follow-up. No cavity problems or bone pâté infections were seen. CONCLUSION: Due to their availability and affordability, bone allografts present a practical option for obliteration of large mastoid cavities and reconstruction of the EAC in retrograde CWDM procedures.
