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Updated: Jun 22, 2026
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Endoscopic Cholesteatoma Surgery
Published on: January 19, 2022
Tympanomastoidectomy: planned second-look tympanotomy
Patrick J D Dawes1, Mohannad Al-Qudah
1Department of Otorhinolaryngology-Head and Neck Surgery, Department of Medical and Surgical Sciences, Medical School, University of Otago, Dunedin, New Zealand. patrickd@healthotago.co.nz
Summary
Second-look tympanotomy after cholesteatoma surgery effectively controls residual disease. This planned procedure aids in managing middle ear pathology, showing excellent early results for selected patients.
Area of Science:
- Otolaryngology
- Surgical Outcomes
- Middle Ear Disease
Background:
- Cholesteatoma and retraction pockets are common middle ear diseases.
- Canal wall down mastoid surgery is a primary treatment.
- Residual disease necessitates further management.
Purpose of the Study:
- To evaluate the outcomes of second-look tympanotomy in patients with cholesteatoma/retraction pocket disease.
- To assess the efficacy of planned second-look procedures for disease control.
Main Methods:
- Retrospective analysis of 158 patients (163 ears) undergoing canal wall down mastoid surgery (1993-2003).
- Data collection focused on second-look tympanotomy recommendations, surgical findings, and hearing thresholds.
- Comparison of outcomes between single-stage and staged (second-look) surgical approaches.
Main Results:
- Of 36 patients recommended for second-look tympanotomy, 32 underwent the procedure, with 30 disease-free.
- Mean bone conduction thresholds showed minimal change post-surgery in both single-stage and second-look groups.
- Air-bone gaps at 1 year were comparable between single-stage (24.6 dB) and staged (28.6 dB) surgery.
Conclusions:
- Planned second-look tympanotomy provides excellent early control of residual cholesteatoma/retraction pocket disease.
- This approach facilitates effective management of middle ear pathology.
- Second-look tympanotomy is a valuable strategy for selected patients post-mastoid surgery.
