The marsupialized (radical) mastoid

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Abstract
The state of 119 marsupialized mastoids (61 conservative (modified) radicals and 58 radical cavities) was evaluated. Four factors were related to the dryness of a mastoid cavity. The small cavities were dry in 87.5%, whereas they were dry in the large ones in only 61%. Ears with a low facial ridge were dry in 77% whereas, when the ridge was high, only 20% were dry. Ears with an adequate or optimal external meatus were dry in 85%, whereas they were dry in only 30 and 68%, respectively, when the meatus was stenosed or very large. Of the radical cavities, 51% developed spontaneously a neotympanic membrane of one size or another; these were dry in 82%, a figure similar to the ears with conservative (modified) radical cavities (81%). An exposed promontory reduced the percentage of dry ears to 50%. Whenever all of these 4 factors were present simultaneously, 94% of the ears were dry. Whenever one of the factors was adversely present, inferior results were found. When all 4 factors were unfavorable, 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 favorable outcome of each of the 4 factors depends much on the surgeon. 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. Apparently, the results of radical and conservative (modified) radical mastoidectomies, if well performed, are better than their reputation suggests.