[Efficacy of Topical Medications in Mastoid Cavity Care Following Canal Wall Down Mastoidectomy. (A Retrospective Cohort Study)].

UNLABELLED: Postoperative management of mastoid cavities after canal wall down (CWD) mastoidectomy remains challenging due to persistent otorrhea, infection, and delayed healing. Topical medications are widely used, but comparative data on their efficacy are limited.

OBJECTIVE

To evaluate the outcomes of different topical medications in patients with mastoid cavities following CWD mastoidectomy.

MATERIAL AND

METHODS

A retrospective cohort study of 128 patients treated between 2015-2022. Groups included quinolone antibiotic drops (n=45), antiseptic agents (n=38), antifungal solutions (n=25), and combination therapy (n=20). Primary outcomes were resolution of otorrhea and epithelialization time. Secondary outcomes included complications and microbial resistance.

RESULTS

Combination therapy (quinolone antibiotic + antiseptic) achieved the highest otorrhea resolution rate (95%) and shortest epithelialization time (6.2±1.8 weeks). Antifungal agents had the lowest efficacy (68% resolution). Pseudomonas aeruginosa (32%) and Staphylococcus aureus (24%) were predominant pathogens, with quinolone antibiotic resistance observed in 18%.

CONCLUSION

Combination topical therapy optimizes mastoid cavity healing, while antifungal agents should be reserved for confirmed fungal infections.