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Canal-wall-down tympanoplasty with mastoidectomy for advanced cholesteatoma
1Department of Otorhinolaryngology, Head and Neck Surgery, Changhua Christian Hospital, Taiwan.
Objective:
The objective of this study was to review 8.5 years of the senior author's experience with canal-wall-down mastoid surgery for extensive cholesteatoma with high-grade atelectasis and severely destructed ossicles.
Design:
A retrospective review was conducted.
Setting:
The setting was a tertiary care medical centre.
Methods:
Available records consulted included 104 canal-wall-down mastoidectomy for advanced-stage cholesteatomas between July 1984 and December 1992.
Main Outcome Measures:
Recurrence, hearing results, and dry ear rate were analyzed.
Results:
The recurrence rate was 4 of 104 (3.8%), and 9.6% of subjects suffered from recurrent otorrhea. Thirty-seven of 104 (35.6%) achieved the closure of air-bone gap within 20 dB. The availability of stapes suprastructure influenced the postoperative hearing level significantly (p < .001).
Conclusion:
Even in treating advanced cholesteatoma, canal-wall-down mastoidectomy provides a low recurrence rate, establishes a high dry ear rate, and preserves adequate hearing when the stapes suprastructure is available for reconstruction.