Canal-wall-down tympanoplasty with mastoidectomy for advanced cholesteatoma.
OBJECTIVE
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.


METHODS
A retrospective review was conducted.


METHODS
The setting was a tertiary care medical centre.


METHODS
Available records consulted included 104 canal-wall-down mastoidectomy for advanced-stage cholesteatomas between July 1984 and December 1992.


METHODS
Recurrence, hearing results, and dry ear rate were analyzed.


RESULTS
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).


CONCLUSIONS
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.
Chang
C C
CC
Department of Otorhinolaryngology, Head and Neck Surgery, Changhua Christian Hospital, Taiwan.
Chen
M K
MK
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D018424:Cholesteatoma, Middle Ear / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008416:Mastoid / Q000601:surgery; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome; D014433:Tympanoplasty / Q000379:methods*