Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
September 22, 2026 · via Europe PMC
Mastoid Obliteration in Addition to the Canal Wall Up Tympanomastoidectomy: A Systematic Review.
Erfurt C, de Rooij MJ, Straatman LV, Thomeer HGXM.
AI summary — for doctors, generated from the abstract only
Adding mastoid obliteration to canal wall up tympanomastoidectomy appears to reduce cholesteatoma recidivism, but no high-level evidence exists.
What was studied
A systematic review of studies evaluating canal wall up tympanomastoidectomy with vs without obliteration for cholesteatoma in adults.
Key findings
- Four comparative and five noncomparative retrospective studies addressed recurrence
- Nearly all studies indicated reduced recidivism with obliteration
- No prospective studies, RCTs or economic evaluations were found
- Significant heterogeneity among studies
Clinical relevance
Suggests obliteration may help, but evidence is retrospective and likely confounded, precluding firm conclusions.
Who should care
Limitations
Only retrospective studies with confounding and heterogeneity.
Mastoid obliteration looks promising but needs prospective evidence.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Purpose
This systematic review aimed to summarize the available evidence on clinical, patient-related, and economic outcomes of the canal wall up (CWU) tympanomastoidectomy, with and without the obliteration technique in surgical cholesteatoma care.
Methods
A comprehensive search was conducted in PubMed, Embase, Cochrane, Scopus, ClinicalTrials.gov, and the EU Clinical Trials Register. The NHS EED database was also searched for economic evaluations. All searches were completed by July 7, 2025. Studies were included if they evaluated the obliteration technique alongside CWU or compared it to CWU without obliteration in adults. The primary outcome was recurrent/residual disease. Secondary outcomes included hearing results, complications, quality of life, and economic evaluations. Two authors independently screened and included the literature; quality assessment was assessed by all authors and determined by consensus.
Results
Four comparative and 5 noncomparative retrospective studies addressed the primary outcome. Surgical complications were reported in all but one of the articles. Three additional studies focused on secondary outcomes: 2 on quality of life and 1 on hearing. No studies were identified on economic evaluations or cost analyses. Furthermore, no prospective studies or randomized controlled trials were found.
Conclusion
The results of nearly all included studies indicate a reduction in recidivism rates when the obliteration technique is added to the canal wall up (CWU) approach. However, no high-level evidence studies are currently available, and the existing studies are likely subject to confounding factors. In addition, significant heterogeneity among the studies limits the ability to draw definitive conclusions at this stage.
DOI
10.1097/mao.0000000000005075
PMID
42771949
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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