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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
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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

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