Surgical treatment of cholesteatoma: a comparison of closed and open techniques in a follow-up of 164 ears.
In the Malmö community (230,000 inhabitants) 188 ears with cholesteatoma were operated on during 1975-1981. This number corresponds to an incidence of 12 cholesteatomas per 100,000 inhabitants a year. A detailed follow-up was possible in 164 ears. The primary operation was performed with an intact canal wall technique (CAT) in 148 ears and a radical operation in 40 ears. A planned second look was performed in 138 of the CAT ears and residual cholesteatoma was found in 41 or 30%, mainly in the epitympanic space. An initially good healing and hearing result was obtained in 71% but in the course of time several ears developed new retractions and a new mastoid cholesteatoma. The number of ears with perfect hearing tended to decrease with time, but about one-third of CAT ears remained intact with good hearing. The CAT technique is preferable in ears with a large mastoid air cell system and when the cholesteatoma is easily accessible by the approach. A planned second look should be performed including ossiculoplasty and obliteration of the antrum. In the remaining cases a radical operation including middle ear reconstruction and obliteration of the mastoid cavity is preferred.
ENT Department, General Hospital, Malmö, Sweden.
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A
Reimer
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L
Andreasson
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S
Harris
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002781:Cholesteatoma / Q000601:surgery*; D004427:Ear Diseases / Q000601:surgery*; D004429:Ear Ossicles / Q000601:surgery; D005064:Eustachian Tube / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006309:Hearing; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008722:Methods; D008875:Middle Aged; D011183:Postoperative Complications; D012086:Reoperation