09-11, 07:15–07:30 (Europe/Istanbul), Otology 6
1. Description
Canal wall–down mastoidectomy (CWDM) often leaves troublesome cavities. This session synthesizes my prospective and retrospective clinical experience with four obliteration strategies in large CWDM defects: allogenic cancellous bone allograft, butterfly silicone block, amniotic membrane covering of a musculoperiosteal flap, and temporalis fascia. Using standardized outcomes—time to complete epithelialization, granulation/otorrhea, revision rate, graft success, and AAO-HNS hearing metrics—I will present how each material performs in different anatomic and revision scenarios, and how these data informed a simple, stepwise algorithm for selecting the optimal obliteration material while preserving a dry, stable ear and functional hearing.
2. Outcome Objectives
After the session, participants will be able to:
Analyze indications, advantages, and limitations of bone allograft, silicone block, amniotic membrane, and temporalis fascia in CWDM mastoid obliteration.
Compare epithelialization time, granulation/otorrhea, graft success, and hearing outcomes across the four techniques.
Implement a practical, material-tailored algorithm for planning mastoid obliteration and external auditory canal reconstruction in everyday otologic practice.
Background – Key References
1- Faramarzi M, Kaboodkhani R, Faramarzi A, Roosta S, Erfanizadeh M, Hosseinialhashemi M. Mastoid obliteration and external auditory canal reconstruction with silicone block in canal wall down mastoidectomy. Laryngoscope Investig Otolaryngol. 2021;6(5):1188-1195.
2- Faramarzi M, Kaboodkhani R, Roosta S, Azarpira N, Shishegar M, Bahranifard H. Application of amniotic membrane for covering mastoid cavity in canal wall down mastoidectomy. Laryngoscope. 2019;129(6):1453-1457.
3- Faramarzi M, Atashi S, Edalatkhah M, Roosta S. The effect of anterior tab flap technique on graft success rate in large tympanic membrane perforation. Eur Arch Otorhinolaryngol. 2021;278(6):1765-1772.
4- Faramarzi M, Shishegar M, Kazemi T, Tavakolpour Saleh H, Roosta S. The effect of applying amniotic membrane on post-tonsillectomy pain and bleeding. Eur Arch Otorhinolaryngol. 2021;278(2):485-492.
5-Faramarzi M, Roosta S. Incidence of Facial Nerve Canal Dehiscence in Primary and Revision Cholesteatoma Surgery. Indian J Otolaryngol Head Neck Surg. 2017;69(3):300-306.
To present a practical, evidence-based, material-specific approach to mastoid obliteration in canal wall–down mastoidectomy, showing how allogenic bone allograft, butterfly silicone block, amniotic membrane, and temporalis fascia can be selectively applied to achieve a dry, stable cavity and preserve hearing in complex ears.
Mohammad Faramarzi, M.D., is a Professor of Otolaryngology–Head and Neck Surgery at Shiraz University of Medical Sciences, Shiraz, Iran. He practices at the Department of Otolaryngology–Head and Neck Surgery, Khalili Hospital, Dastgheib Hospital, and Dena Private Hospital.
He completed his fellowship in Otology and Neuro-otology at Tehran University of Medical Sciences (2001–2003) and later obtained a fellowship in Rhinology and Endoscopic Sinus Surgery at Yazd University of Medical Sciences (2010–2011). He also holds the Iranian national board in otolaryngology (1997) and an M.D. from Shiraz University of Medical Sciences (1990).
Professor Faramarzi’s research focuses on otology and middle ear surgery, including stapedotomy, tympanoplasty, ossicular reconstruction, mastoid surgery, and the use of novel materials in ear surgery. He has also contributed significantly to studies on nasal airway physiology, tonsillectomy outcomes, pediatric otolaryngology, and medical education. He is the author or co-author of more than 90 peer-reviewed publications in international journals, including multiple randomized clinical trials in middle ear surgery.
He has received numerous institutional awards for excellence in teaching from Shiraz University of Medical Sciences and the Department of Otolaryngology over many consecutive years, highlighting his longstanding commitment to resident training and medical education. Through his combined clinical, research, and teaching activities, Professor Faramarzi has played a key role in advancing evidence-based otologic and rhinologic surgery in southern Iran and beyond.