Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-12-01T01:17:19.735Z Has data issue: false hasContentIssue false
  • English
  • Français

Extensive cholesteatoma: long-term results of three surgical techniques

Published online by Cambridge University Press:  29 June 2007

Mette Nyrop  and
Per Bonding
Mette Nyrop
Affiliation:
Department of Otolaryngology, Glostrup Hospital, Copenhagen, Denmark.
Per Bonding*
Affiliation:
Department of Otolaryngology, Glostrup Hospital, Copenhagen, Denmark.
*
Address for correspondence: Per Bonding, M.D., Ph.D., Dept. of Otolaryngology, Glostrup Hospital, Copenhagen, DK-2600 Glostrup, Denmark. Fax: (+45) 43 42 22 70
Get access Rights & Permissions [Opens in a new window]

Abstract

During the years 1979–81, three different surgical techniques were used in the treatment of 87 ears with extensive cholesteatoma. All procedures were performed in one stage by the same surgeon. Ten to 13 years after the operations about 70 per cent of ears operated on by the canal wall up technique had developed a new cholesteatoma, which in most cases was recurrent, or a deep retraction pocket. A modification of this technique with mastoid obliteration resulted in a similar failure rate. In contrast, ears operated on by the canal wall down technique (in most cases with mastoid obliteration) had acceptable stability with a long-term recurrence rate of about 15 per cent. Most patients in the canal wall down group had a dry ear without significant cavity problems. Hearing in these patients was as least as good as hearing in patients with a preserved canal wall. We conclude that a meticulous one-stage canal wall down technique in ears with extensive cholesteatoma results in a high percentage of unproblematic, stable ears with satisfactory function. In contrast, if the posteriorcanal wall is preserved, recurrent cholesteatoma is the rule more than the exception.

Keywords

Otitis media, suppurativeSurgery, operativeRecurrence
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 111 , Issue 6 , June 1997 , pp. 521 - 526
Copyright
Copyright © JLO (1984) Limited 1997

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Austin, D. F. (1989) Staging in cholesteatoma surgery. Journal of Laryngology and Otology 103:143–148.Google Scholar
Brackmann, D. E. (1993) Tympanoplasty with mastoidectomy: Canal wall up procedures. American Journal of Otology 14: 380–382.Google Scholar
Cody, D. T. R., McDonald, T. J. (1984) Mastoidectomy for acquired cholesteatoma: follow-up to 20 years. Laryngoscope 94: 1027–1029.CrossRefGoogle ScholarPubMed
Cook, J. A., Krishnan, S., Fagan, P. A. (1996) Hearing results following modified radical versus canal-up mastoidectomy. Annals of Otology, Rhinology and Laryngology 105: 379–383.Google Scholar
Edelstein, D. R., Parisier, S. C. (1989) Surgical techniques and recidivism in cholesteatoma. Otolarynoglogic Clinics of North America 22: 1029–1040.Google Scholar
Hough, J. (1983) The canal wall up or down debate. The case for the canal wall down. Journal of Laryngology and Otology 92: 92–94.Google Scholar
Jansen, C. (1968) The combined approach for tympanoplasty (Report on 10 years experience). Journal of Laryngology and Otology 82: 779–793.Google Scholar
Mercke, U. (1986) Anatomic findings one year after combined approach tympanoplasty. American Journal of Otology 7: 150–154.Google ScholarPubMed
Mercke, U. (1989) Cholesteatoma surgery using combined approach tympanoplasty and staging. A five-year follow-up. In Cholesteatoma and Mastoid Surgery. (Tos, M., Thomsen, J., Peitersen, E., eds.) Kugler and Ghedini Publications, Amsterdam, Berkeley, Milano, pp. 831–833.Google Scholar
Palva, T. (1993) Cholesteatoma surgery today. Clinical Otolaryngology 18: 245–252.Google Scholar
Sadé, J. (1987) Treatment of cholesteatoma. American Journal of Otology 8: 524–533.Google Scholar
Sheehy, J. L. (1978) Recurrent and residual disease in cholesteatoma surgery. Clinical Otolaryngology 3: 393–403.Google Scholar
Smyth, G. D. L. (1985) Cholesteatoma surgery: The influence of the canal wall. Laryngoscope 95: 92–96.Google Scholar
Toner, J. G., Smyth, G. D. L. (1990) Surgical treatment of cholesteatoma: A comparison of three techniques. American Journal of Otology 11: 247–249.Google ScholarPubMed
Tos, M., Lau, T. (1989) Recurrence and condition of the cavity after surgery for cholesteatoma using various techniques. In Cholesteatoma and Mastoid Surgery. (Tos, M., Thomsen, J., Peitersen, E., eds.) Kugler and Ghedini Publications, Amsterdam, Berkeley, Milano, pp 863–869.Google Scholar
Yanagihara, N., Gyo, K., Sasaki, Y., Hinohira, Y. (1993) Prevention of recurrence of cholesteatoma in intact canal wall tympanoplasty. American Journalof Otology 14; 590–594.Google Scholar