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Updated: Aug 15, 2026
Endoscopic Cholesteatoma Surgery
Published on: January 19, 2022
Canal wall reconstruction tympanomastoidectomy with mastoid obliteration
Bruce J Gantz1, Eric P Wilkinson, Marlan R Hansen
1Department of Otolaryngology--Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, 52242, USA. bruce-gantz@uiowa.edu
Objectives:
This study was designed to evaluate the authors' experience with canal wall reconstruction (CWR) tympanomastoidectomy with mastoid obliteration in the treatment of chronic otitis media with cholesteatoma.
Study Design:
Institutional review board approved retrospective case review.
Methods:
Retrospective review was performed of all patients undergoing CWR tympanomastoidectomy with mastoid obliteration from 1997 to 2004. Data included pre- and postoperative audiometry, findings at second look surgery with ossiculoplasty, and postoperative complications including wound infection and canal wall displacement.
Results:
One hundred thirty ears in 127 adults and children underwent the procedure. Mean time postoperative was 48 (range 2-94) months. A second look ossiculoplasty was performed in 102 (78%). Percentage of ears that remain safe without evidence of recurrence was 98.5. The postoperative infection rate decreased from an initial rate of 14.3% to 4.5% for the last 88 ears after protocol modification. Recurrence occurred in two (1.5%) patients, requiring conversion to a canal wall down mastoidectomy.
Conclusions:
A CWR technique can provide improved intraoperative exposure of the middle ear and mastoid without creating a mastoid bowl and reduces the incidence of recurrent disease. A single procedure is used for all patients with acquired cholesteatoma, including children.
