Acetic Acid Instillation after Canal Wall Down Mastoidectomy

• Main Authors: Hamsa Shetty, Gangadhara K S
• Format: Article
• Language: English
• Published: The Association of Otolaryngologists of India, West Bengal 2015-12-01
• Series: Bengal Journal of Otolaryngology and Head Neck Surgery
• Subjects: Otitis Media, Suppurative; Acetic Acid; Mastoid.
• Online Access: http://bjohns.in/journal/index.php/bjohns/article/view/97

Introduction: Persistent otorrhoea and granulation tissue in the mastoid cavity are common post-operative complications of Canal Wall Down Mastoidectomy. In order to avoid the same and to achieve a dry cavity instillation of acetic acid into the mastoid cavity during the post operative period is common practice. Materials and Methods In this study we assessed the results of 4% acetic acid instillation in varying quantity and frequency, in the ears after modified radical mastoidectomy. 40 Patients of chronic suppurative otitis media (atticoantral) / cholesteatoma, who underwent modified radical mastoidectomy during one and a half year period, were included in the study. The patients were divided into two groups; Group A with 30 patients and Group B with 10 patients, by simple randomization method. Group A patients were asked to instill 4% acetic acid approximately 10 to 12 drops (generously) into the mastoid cavity thrice a day for  8 weeks and were followed up every week.  10 patients  of Group B were asked to instill the same preparation only once weekly and followed up for the next 12 weeks.   Results: In Group A, dry mastoid cavity was achieved remarkably faster within six to eight weeks and in all the 30 patients. In Group B the results were delayed by up to 4 to 6 weeks in comparison to the Group A patients. Conclusion:             Though acetic acid instillation is known to help in achieving a dry cavity but a slightly higher concentration (4% acetic acid) used more frequently is highly effective in rendering dry cavity much earlier without proliferation of granulation tissue.