J. LARYNGOL. OTOL. 96/10 (1982) 869-875
Abstract
The state of 119 marsupialized mastoids (61 conservative (modified) radicals and 58 radical cavities) was evaluated. Four factors were found to be related to the dryness of a mastoid cavity: A. The small cavities were dry in 87.5 per cent, whereas they were dry in the large ones in only 61 per cent. B. Ears with a low facial ridge were dry in 77 per cent whereas, when the ridge was high, only 20 per cent were dry. C. Ears with an adequate or optimal external meatus were dry in 85 per cent, whereas they were dry in only 30 per cent and 68 per cent respectively when the meatus was stenosed or very large. D. 51 per cent of the radical cavities developed spontaneously a neotympanic membrane of one size or another; these were dry in 82 per cent, a figure similar to the ears with conservative (modified) radical cavities (81 per cent). An exposed promontory reduced the percentage of dry ears to 50 per cent. Whenever all these four factors were present simultaneously, 94 per cent of the ears were found to be dry. Whenever one of the factors was adversely present, inferior results were found. When all four factors were unfavourable, dry ears were found (by extrapolation) to be almost nil. It seems that performing an ideal 'radical cavity' (modified or not) needs more attention than is often realized - as a favourable outcome of each of the four factors depends much upon the surgeon. We are also under the impression that patients who are followed up once or twice a year for cleaning the smallest amount of debris from the mastoid, fare better than patients who are left completely on their own. Our conclusion is that the results of radical and conservative (modified) radical mastoidectomies, if well performed, are better than their reputation suggests.