Which technique is better for cholesteatoma surgery?
M. Deniz , C. Uslu , Ç.Kolda and B. Deniz
Department of Otorhinolaryngology, Namk Kemal University, Medical Faculty, Tekirda, Turkey; Department of Otorhinolaryngology,MedicalFaculty,MedipolUniversity,Fatih,Istanbul,Turkey; Department4fOtorhinolaryngology, Haydarpaa Numune Education and Research Hospital, Kadköy, Istanbul, Turkey; Faculty of Education, Boaziçi University, Bebek, Istanbul, Turkey
Otitis media; cholesteatoma; mastoidectomy; recurrence
109 - 115
Which technique is better for cholesteatoma surgery? Objective: The objective of this study was to evaluate the long-term surgical outcomes and recurrence rates of three surgical techniques that are commonly used for cholesteatoma. Patients and methods: The hospital records of 132 patients with primary cholesteatoma who underwent surgery between January 1996 and December 2006 were evaluated retrospectively. Twelve cases had bilateral disease, and a total of 144 ears were treated. The patients were divided into three groups according to surgical technique: modified radical mastoidectomy (MRM) (n=48 ears), radical mastoidectomy (RM) (n =42 ears), and intact canal wall mastoidectomy (ICWM) (n=54 ears). MRM and RM procedures are canal wall down (CWD) techniques, whereas the ICWM procedure is a canal wall up (CWU) technique. Postoperatively, all patients were followed up yearly for at least 6 years. The otomicroscopic features, cholesteatoma extension, surgical findings, and recurrence rates were compared in the groups. Results: Preoperative otomicroscopic examination showed attic retraction or perforation in 32% of the cases and central perforation in 11%. There was a higher cholesteatoma recurrence rate in the ICWM group than in the MRM and RM groups (p<0.05), but there was also better hearing gain in the ICWM group (p<0.05). Conclusion: There are several surgical techniques for eradicating cholesteatoma. Our study found that CWD procedures (RM,MRM)weremoreeffectivefortheeradicationofcholesteatoma,buthearinggainwasbetterwhenaCWUtechnique was used. The choice of surgical technique should be individually tailored based on the pre-operative imaging and hearing examination findings.
Vol. 11, 2015, 2nd trimester

Which technique is better for cholesteatoma surgery?