Canal-wall-down tympanoplasty with mastoidectomy for advanced cholesteatoma
Chang, C.C.; Chen, M.K.
Journal of Otolaryngology 29(5): 270-273
2000
ISSN/ISBN: 0381-6605 PMID: 11108484 Document Number: 516175
The objective of this study was to review 8.5 years of the senior author's experience with canal-wall-down mastoid surgery for extensive cholesteatoma with high-grade atelectasis and severely destructed ossicles. A retrospective review was conducted. The setting was a tertiary care medical centre. Available records consulted included 104 canal-wall-down mastoidectomy for advanced-stage cholesteatomas between July 1984 and December 1992. Recurrence, hearing results, and dry ear rate were analyzed. The recurrence rate was 4 of 104 (3.8%), and 9.6% of subjects suffered from recurrent otorrhea. Thirty-seven of 104 (35.6%) achieved the closure of air-bone gap within 20 dB. The availability of stapes suprastructure influenced the postoperative hearing level significantly (p < .001). Even in treating advanced cholesteatoma, canal-wall-down mastoidectomy provides a low recurrence rate, establishes a high dry ear rate, and preserves adequate hearing when the stapes suprastructure is available for reconstruction.