Postauricular approach atticotomy: a modified closed technique with reconstruction of the scutum with cymbal cartilage.
OBJECTIVE
We studied the results of postauricular approach atticotomy in patients with cholesteatoma of the anterior epitympanum.


METHODS
Twenty-six patients were selected for removal of cholesteatoma of the anterior epitympanum by postauricular approach atticotomy, a closed transcanal procedure that is used to expose and remove cholesteatoma. After removal of cholesteatoma, reconstruction of the scutum is performed with cymbal cartilage.


RESULTS
Postauricular approach atticotomy can be performed as part of a canal wall-up procedure in selected cases in which cholesteatoma invades the anterior epitympanum. Especially if the ossicular chain is intact and if there is an anteriorly curved medial outer canal wall, this technique is useful in avoiding an open technique. A second-look procedure is recommended because of a relatively high percentage of recurrent and residual disease.


CONCLUSIONS
Postauricular approach atticotomy with reconstruction of the scutum is a useful technique to remove cholesteatoma from the anterior epitympanum.
Department of Otorhinolaryngology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands.
Ronald J E
RJ
Pennings
Cor W R J
CW
Cremers
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D018424:Cholesteatoma, Middle Ear / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D004425:Ear Cartilage / Q000601:surgery; D004429:Ear Ossicles / Q000601:surgery; D034381:Hearing Loss / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D013524:Surgical Flaps; D016896:Treatment Outcome; D014432:Tympanic Membrane; D014433:Tympanoplasty / Q000379:methods*; D055815:Young Adult