title: Anterior atticoantrostomy for cholesteatoma surgery.
abstract: OBJECTIVE
  We aimed to investigate the long-term results of anterior atticoantrostomy in adult patients with cholesteatoma.
  
  
  METHODS
  A total of 83 ears in 78 patients were operated on by the anterior atticoantrostomy technique, supported by a periosteal flap, between 1991 and 2002.
  
  
  RESULTS
  Cholesteatoma recurred in only 4 ears (4.8%). In the 79 ears without recurrence, re-perforation was observed in 3 ears (3.8%), and retraction pockets developed in the attic of 5 ears (6.3%), 2 of which needed ventilation tubes. Absorption or migration of cartilage grafts was not seen in any of the patients. The mean air-bone gap was 34.8 +/- 13.4 dB and 16.9 +/- 14.7 dB, and the mean high-tone bone conduction was 19.0 +/- 6.2 dB and 21.1 +/- 6.6 dB, in the preoperative and postoperative periods, respectively.
  
  
  CONCLUSIONS
  In the reconstruction of the posterior canal wall, a cartilage graft supported by a periosteal flap prevents attic retraction and may increase the vascularization of the graft. After anterior atticoantrostomy, the recurrence rate and the probability of leaving residual tissue are low. Therefore, we believe that anterior atticoantrostomy is a relatively safe and effective technique that can be used in the management of cholesteatoma.
authors.affiliation: Department of Otolaryngology, Meram Faculty of Medicine, Selçuk University, Konya, Turkey.
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Uyar
authors.forename: Kayhan
authors.initials: K
authors.lastname: Oztürk
authors.forename: Bahar
authors.initials: B
authors.lastname: Keles
authors.forename: Hamdi
authors.initials: H
authors.lastname: Arbağ
authors.forename: Cağatay Han
authors.initials: CH
authors.lastname: Ulkü
mesh_terms: D000293:Adolescent; D000328:Adult; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold; D001844:Bone Conduction; D018424:Cholesteatoma, Middle Ear / Q000601:surgery*; D016208:Databases, Factual; D004432:Ear, Middle / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008416:Mastoid / Q000601:surgery*; D008875:Middle Aged; D013506:Otologic Surgical Procedures / Q000379:methods*; D012008:Recurrence; D012189:Retrospective Studies; D013524:Surgical Flaps; D016896:Treatment Outcome; D014432:Tympanic Membrane / Q000601:surgery