[Factors determining the choice of technic in surgical treatment of cholesteatoma].
One hundred patients who underwent surgery using either an open or a closed technique for cholesteatoma removal were studied with the aim of establishing the criteria for deciding the choice of the surgical technique. It is clear that purely anatomical criteria, although valid, are insufficient. Results show that there are other elements such as the condition of mucosa, the presence of tubal dysfunction as well as the characteristics of the pathological condition like the clinical and surgical type of cholesteatoma, its location and extension which are as important as the anatomical considerations. Maximal risk groups for the occurrence of complications and failures (residual cholesteatoma, recurrence, reinfection, and probabilities of achieving success from a functional point of view) are established. Preoperative factors that can influence results are analyzed. It is concluded that the choice of a surgical technique--regarding both the surgical approach and type of reconstruction--has to be made intraoperatively, although once a decision is made the technique employed should be one perfectly standardized and included into one of the two possibilities: a closed technique (tympanoplasty with mastoidectomy, with or without subsequent tympanotomy and second surgical inspection after one year), and an open technique (removal and outpatient follow up).
Antolí-Candela Cano
F
F
Leguizamón Medina
G
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002781:Cholesteatoma / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D004427:Ear Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D004432:Ear, Middle / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008416:Mastoid / Q000601:surgery; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D012008:Recurrence; D014433:Tympanoplasty / Q000379:methods
Factores que determinan la selección de la técnica en el tratamiento quirúrgico del colesteatoma.