Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Apr 7;17(4):e81837.
doi: 10.7759/cureus.81837. eCollection 2025 Apr.

Comparative Study of Postoperative Healing Outcomes With and Without Medicated Cavity Packing Following Canal Wall Down (CWD) Mastoidectomy

Mani Mala  1 , Richi Sinha  1 , Rakesh K Singh  1
Affiliations

Comparative Study of Postoperative Healing Outcomes With and Without Medicated Cavity Packing Following Canal Wall Down (CWD) Mastoidectomy

Mani Mala et al. Cureus. .

Abstract

Objective The objective of this study was to evaluate the effect of postoperative medicated mastoid cavity packing on healing outcomes following canal wall down (CWD) mastoidectomy compared to no packing. Methods This prospective observational study included 125 patients undergoing CWD mastoidectomy, matched for age and sex, and assigned to two groups. Group A (n=62) received medicated mastoid cavity packing containing ofloxacin, ornidazole, clobetasone propionate, and itraconazole on postoperative days 0, 10, and 20. Group B (n=63) received no postoperative packing. Healing outcomes were evaluated and compared between the groups on postoperative days 45, 75, and 105. A p-value of <0.05 was considered statistically significant. Results The groups were comparable in age and sex distribution. The packed group demonstrated significantly higher rates of complete epithelialization on day 45 (48.4% vs. 15.9%, p < 0.0001) and day 75 (72.6% vs. 49.2%, p = 0.007), with no difference observed by day 105. Graft uptake duration was similar between groups (76.94 days in Group A and 76.19 days in Group B). Granulation tissue, mucosal folds, and otorrhea were more frequent in the non-packed group (25.4%, 6.3%, and 4.8% vs 12.9%, 3.2%, and 3.2%, respectively) during early follow-up, though not statistically significant. Mean epithelialization time was significantly shorter in the packed group (84.0 vs. 92.8 days, p = 0.001). Conclusion Medicated mastoid cavity packing promotes earlier epithelialization following CWD mastoidectomy and is associated with a lower incidence of granulation tissue without affecting graft uptake. It offers particular benefits in low-resource settings by enhancing healing and reducing follow-up needs. Larger studies are warranted to establish standardized postoperative care protocols.

Keywords: canal wall down mastoidectomy; chronic suppurative otitis media; epithelialization; ointment pack; postoperative healing.

PubMed Disclaimer

Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Indira Gandhi Institute of Medical Sciences, Patna, India, Institutional Ethics Committee issued approval 1470/IEC/IGIMS/2024, dated 20/03/2024. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: Mani Mala declare(s) a grant from Indira Gandhi Institute of Medical Sciences, Patna, India. The Multidisciplinary Research Unit, Indira Gandhi Institute of Medical Sciences, Patna, a scheme of the Department of Health Research, Government of India, funded this study. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Intraoperative photographs
(A) The conventional packing of the mastoid cavity with gel foam; (B) Packing of the mastoid cavity with ribbon gauze impregnated with combination ointment
Figure 2
Figure 2. Line diagram showing the postoperative incidence of discharge, granulation tissue formation, and mucosal fold development in Group A (with pack) and Group B (without pack) over time
Figure 3
Figure 3. Kaplan–Meier survival curves
(A) Time to complete epithelialization in Group A (with pack) and Group B (without pack); (B) Time to graft uptake in Group A (with pack) and Group B (without pack)
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Prevalence of chronic suppurative otitis media (CSOM) and associated hearing impairment among school-aged children in Yemen. Muftah S, Mackenzie I, Faragher B, Brabin B. Oman Med J. 2015;30:358–365. - PMC - PubMed
    1. Chronic suppurative otitis media: a comprehensive review of epidemiology, pathogenesis, microbiology, and complications. Khairkar M, Deshmukh P, Maity H, Deotale V. Cureus. 2023;15:0. - PMC - PubMed
    1. Prevention of hearing impairment from chronic otitis media: report of a WHO/CIBA Foundation Workshop, London, U.K., 19-21 November 1996. https://iris.who.int/handle/10665/63870 WHO/CIBA Foundation Workshop, London, U.K., 19-21 November. 2024;25:2025.
    1. Evaluation of the current bacterial pathogens and antibiogram of chronic suppurative otitis media in adults. Kawatra R, Pandey S, Agarwal A, Tholia J. Indian J Otolaryngol Head Neck Surg. 2023;75:3072–3076. - PMC - PubMed
    1. Chronic suppurative otitis media. Morris P. https://pubmed.ncbi.nlm.nih.gov/23870746/ BMJ Clin Evid. 2012;2012:507. - PMC - PubMed

LinkOut - more resources