title: Surgical management of sinus tympani cholesteatoma.
abstract: OBJECTIVE
  the aim of this study is to describe the extension of unsafe middle ear disease in the sinus tympani and to review the methods of surgical access to remove the disease from this area.
  
  
  METHODS
  Of the 164 operated ears with unsafe chronic suppurative otitis media 64(39%) ears had variable disease extension into the sinus tympani and were included in the study. Sixty two ears underwent canal wall down (CWD) procedure while remaining two underwent tympanoplasty with bone work.
  
  
  RESULTS
  Five operated ears had deeper extension of the disease into the sinus tympani. And despite of different maneuver the complete removal of the disease could not be confirmed. Six ears (9.4%) had recidivism.
  
  
  CONCLUSIONS
  The study emphasizes on the greater incidence of this disease extension into this difficult anatomical area and their complete removal may not be always possible. But one should require thorough knowledge and surgical expertise to work in this difficult area of posterior mesotympanum.
authors.affiliation: Dept of ENT-HNS, Kathmandu Medical College Teaching Hospital. torankc@yahoo.com
authors.forename: K C
authors.initials: KC
authors.lastname: Toran
authors.forename: S
authors.initials: S
authors.lastname: Shrestha
authors.forename: P
authors.initials: P
authors.lastname: Kafle
authors.forename: S K
authors.initials: SK
authors.lastname: Deyasi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D018424:Cholesteatoma, Middle Ear / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence