[A new external canal wall-preserving method for aural cholesteatoma surgery--the osteocutaneous flap]

There are three major results of successful aural cholesteatoma surgery. They are called cavity opened, cavity obliterated and cavity closed (Table 1). Cavity opened or cavity closed, call for the use of canal wall down (CWD) or canal wall up (CWU), respectively. With an obliterated cavity, either the canal wall down or canal wall up method may be used. An intermediate form for management of the canal wall is called temporary CWD and two methods of this form have been used. One is the temporary posterosuperior canal wall resection method and the other is the one the author describes here, the osteocutaneous flap for wall preservation. The author used this method after deciding to cut down the canal wall in the case of difficult removal of cholesteatoma in the epitympanum or the middle ear recesses under the CWU procedure. In fifteen cases in the past 2 years this method has been used to complete operations which initially began with the CWU procedure. The results included short healing time, less post-operation care, fair hearing recovery and optimal conditions for a smooth and safe 2nd operation. The osteocutaneous flap method gives us one more choice in the many different methods of cholesteatoma surgery.