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Chronic Ear Infections

The Chronic Discharging Ear (CSOM) and Cholesteatoma

Chronic suppurative ear disease with or without cholesteatoma is a destructive process affecting the middle ear or mastoid. This can include damage to the facial nerve producing paralysis of the face; to the inner ear, producing complete deafness and intense vertigo; and to the brain and meninges, where the serious and possibly fatal conditions of brain abscess and meningitis will occasionally develop.

The members of the department at St Vincent’s Hospital have extensive experience of the surgery of chronic ear disease and cholesteatoma. This can be highly complex surgery which is tailored to the extent of disease. Types of surgery include Intact Canal Wall Mastoidectomy and Modified Radical Mastoidectomy.

Selected Publications:

Buchanan D,Fagan PA, (1991) “Results of Modified Radical Mastoidectomy: 100 cases”, J Otolaryng Soc Austral. 6: 371-374.

Fagan PA, (1991) “Modified Radical Mastoid Surgery for Chronic Ear Disease” Annals of the Acad. of Med Singapore (Otorhinolaryngology). Vol 20:5, 665-673.

Sillars H, Whitfield C, Fagan PA, (1993) “Hearing Results after Modified Radical Mastoid surgery: Aust J Otolaryng. 1:4 325-328.

Fagan PA, Black B: (1994) “Chronic Perforations of the Tympanic Membrane: Mod Med Aust 100-111.

Perez de Tagle J, Fenton JE,Fagan PA, (1996) “Mastoid Surgery in the Only Hearing Ear” Laryngoscope 106: 67-70.

Cook JA, Krishnan S, Fagan PA, “Hearing Results of Modified Radical Mastoidectomy versus Canal Up Surgery” Annuls Otol Rhinol Laryngol 105: 379-382.

Gallagher R Fagan PA (1998) “Posterior Semicircular Canal Fistula – An Unusual Complication of Chronic Destructive Disease of the Mastoid” Aust J Otolaryngol 3: 62-64.

Mukherjee P,Fagan PA, Saunders N, Liu R (2004) “Long-term Outcome of Modified Radical Mastoidectomy”.

Adal M, Turner J,Fagan PA (1999) “Brain Herniation into the Middle Ear” Aust J Otolaryng, 3 (4) 335-336.

Rodrigues S,Fagan PA, Doust BD, Moffat K (2003) “A Radiological Study of the Tympanic Bone” Anatomy and surgery “Otol and Neuro-Otol” 24 796-799.

Sanna M, Dispenza F, Flanagan S, De Stefano A, Falcioni M. Management of chronic otitis by middle ear obliteration with blind sac closure of the external auditory canal. Otol Neurotol 2008;29:19-22.

See also St Vincent's Ear, Acoustic Neuroma, and Skullbase Courses for clinicians.