[Is the "second look" justified after cholesteatoma surgery according to the closed technique? (Our concept of "indicator-pearl")].
Among 1218 tympanoplastic operations of the last three years we found 507 cholesteatomas. In primary operations we chose the closed technique for 287 and the open technique for 77. In 143 cholesteatoma post operations 60 remained closed but 83 were already been modified in favour of the open technique. In 123 "Second look" operations we found 25 recurrences, i.e. 20%. This results in the following aspects: 1. In spite of strictest indications for the closed technique we found recurrences in 20% of the necessary "Second look" operations. In all cases we could maintain the closed technique. This alone justifies the "Second look". 2. No ideal time for the performing the "Second look" to exclude a further recurrence can be named. We believe according to our experience that the most favourable time to operate is after one year. After such a period a recurrence shows itself consequently in a "stadium nascendi" in form of a small pearl, being a carrier of an epithelial rest, which can be easily removed. We call this finding "Indicator-Pearl".
D002781:Cholesteatoma / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D012008:Recurrence; D012086:Reoperation; D014433:Tympanoplasty / Q000379:methods*
Ist der "Second look" nach Cholesteatom-Operation bei geschlossener Technik berechtigt? (Unser Begriff der "Indikatorperle").