Mastoidectomy reconstruction of the posterior wall and obliteration (MAPRO): Preliminary results

Conclusions: Our preliminary results indicate that mastoidectomy by reconstruction of the posterior wall and obliteration (MAPRO) avoided the disadvantages of a canal-wall-down mastoidectomy. MAPRO effectively prevented cholesteatoma recurrence, provided an excellent basis for hearing restoration, and was generally water-safe. Objective: To evaluate the authors' experience with the MAPRO technique for eradication of cholesteatomas requiring canal-wall-down mastoidectomy. Methods: The medical files of all the patients who underwent MAPRO for cholesteatoma between 2008 and 2011 at the Sheba Medical Center were retrospectively reviewed. Results: This series included 49 patients (31 children and 18 adults). The index operation was the first procedure for 30 patients and repeat surgery for 19 patients. Eight patients underwent ossiculoplasty. The mean postoperative follow-up was 28 months. Water tolerance and absence of inflammation were achieved in 93.3% of the first-time group and in 73.7% of the repeat group. (Recurrent cholesteatoma was found on the postoperative non-echo planar base diffusion-weighted magnetic resonance imaging in six (12.2%) patients: three (10%) in the first-time group and three (15.8%) in the repeat group).