Efficacy of the 2-staged procedure in the management of cholesteatoma.
OBJECTIVE
To demonstrate the efficacy of intact canal wall procedure coupled with a second-stage exploration for the treatment of cholesteatoma.


METHODS
Retrospective case study of patients with cholesteatomas treated with staged surgical extirpation. A minimum of 6 months' postoperative follow-up time was required for inclusion into the study.


METHODS
Tertiary academic referral center. Patients A total of 35 adult and pediatric patients, ranging from 9 to 65 years of age, who underwent 2-stage procedures for removal of cholesteatomas.


METHODS
Two-stage procedures, separated by 6 months, performed with posterior tympanotomy approaches.


METHODS
The presence or absence of cholesteatoma on second-stage look and the subsequent surgical treatment for recurrent cholesteatoma. The overall hearing results after the completion of the 2-staged procedure were calculated.


RESULTS
Disease was controlled in 26 (74%) of the patients. Residual and/or recurrent cholesteatomas were found in 9 (26%) of the patients during the second-stage operation. Of these patients, 5 (14% of the total group) ultimately required conversion to canal-wall-down procedure. Average hearing gain at the completion of the second-stage procedure was 9 dB.


CONCLUSIONS
A planned 2-stage procedure that uses the posterior tympanotomy approach for the control of cholesteatoma is an effective technique. This approach offers significant potential for hearing preservation and restoration.
Ho
Steven Y
SY
Department of Otolaryngology, Northwestern University School of Medicine, Evanston, Ill 60202, USA. syh_me109g@yahoo.com
Kveton
John F
JF
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D018424:Cholesteatoma, Middle Ear / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013506:Otologic Surgical Procedures; D012008:Recurrence; D012189:Retrospective Studies; D024162:Second-Look Surgery; D016896:Treatment Outcome; D014432:Tympanic Membrane / Q000601:surgery