Improvements to staged canal wall up tympanoplasty for middle ear cholesteatoma.
OBJECTIVE
To describe our improvements to staged canal wall up tympanoplasty with mastoidectomy (SCUT) for middle ear cholesteatoma, and to show more successful outcomes of the surgery compared with our data previously reported.


METHODS
Retrospective study in a tertiary referral hospital.


METHODS
78 ears of 76 patients with extensive cholesteatoma were operated on using the improved SCUT between July 1998 and December 2006. Improved SCUT included new techniques such as scutum plasty and mastoid cortex plasty performed in a staged manner.


RESULTS
Only 2 ears showed retraction pocket formation (7.7%) without recurrence in 26 ears followed for more than 5 years. In 48 followed for more than 3 years, frequency of postoperative retraction pocket formation (5/48; 10.4%) was significantly lower compared to our previous results (41/134; 30.6%, P < 0.01).


CONCLUSIONS
Our improvements to SCUT contributed to the decreasing of frequency of postoperative retraction pocket that may lead to cholesteatoma recurrence, although a longer follow-up study is required.
Department of Otolaryngology, Takanoko Hospital, Ehime, Japan.
Yasuyuki
Y
Hinohira
Naoaki
N
Yanagihara
Kiyofumi
K
Gyo
D000293:Adolescent; D000328:Adult; D000368:Aged; D001299:Audiometry; D001309:Auditory Threshold / Q000502:physiology; D001843:Bone Cements / Q000627:therapeutic use; D018786:Bone Substitutes / Q000627:therapeutic use; D018424:Cholesteatoma, Middle Ear / Q000601:surgery*; D017886:Durapatite / Q000627:therapeutic use; D004424:Ear Canal / Q000601:surgery; D004429:Ear Ossicles / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008416:Mastoid / Q000601:surgery*; D008875:Middle Aged; D009225:Myringoplasty; D019933:Ossicular Replacement; D038781:Otoscopy; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome; D014433:Tympanoplasty / Q000379:methods*
D001843:Bone Cements; D018786:Bone Substitutes; D017886:Durapatite