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Related Experiment Video

Updated: Apr 4, 2026

Endoscopic Cholesteatoma Surgery
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Endoscopic Cholesteatoma Surgery

Published on: January 19, 2022

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Hearing outcome after sequential cholesteatoma surgery.

Susen Lailach1, Thomas Zahnert2, Nikoloz Lasurashvili2

  • 1Department of Otorhinolaryngology, Head and Neck surgery, Technische Universität Dresden, Medizinische Fakultät Carl Gustav Carus, Fetscher Strasse 74, 01307, Dresden, Saxony, Germany. susen.lailach@uniklinikum-dresden.de.

European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
|September 4, 2015
PubMed
Summary

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Sequential cholesteatoma surgery offers excellent hearing outcomes. Techniques like exclusively transcanal (ETC) and combined transcanal-transmastoidal (TCM) surgery yield better results than canal wall down (CWD) procedures, with partial ossicular replacement prostheses (PORP) showing superior outcomes.

Area of Science:

  • Otolaryngology
  • Audiology
  • Surgical Innovation

Background:

  • Cholesteatoma surgery aims to eradicate disease and preserve/restore hearing.
  • Different surgical techniques and ossicular reconstruction methods impact audiological outcomes.

Purpose of the Study:

  • To evaluate hearing results after sequential cholesteatoma surgery using exclusively transcanal (ETC), combined transcanal-transmastoidal (TCM), and canal wall down (CWD) techniques.
  • To analyze the effect of partial ossicular replacement prostheses (PORP) versus total ossicular replacement prostheses (TORP) on hearing outcomes.

Main Methods:

  • Retrospective case review of 376 cholesteatoma surgeries (2007-2009) with 92 ears examined postoperatively.
  • Comparison of pre- and postoperative air-bone gap (ABG) and air conduction thresholds (AC) for 0.5-3 kHz.
Keywords:
Canal wall downCanal wall upCholesteatomaHearing outcomeIntact canal wallOssiculoplastyPartial ossicular reconstruction prosthesesTotal ossicular reconstruction prosthesesTympanoplasty

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  • Stratification by surgical technique (ETC, TCM, CWD) and ossiculoplasty (PORP, TORP).
  • Main Results:

    • Overall mean ABG improved from 25.3 dB to 19.8 dB (5.4 dB closure).
    • Canal wall down (CWD) surgery resulted in worse postoperative ABG (23.5 dB) compared to ETC (17.3 dB) and TCM (19.4 dB).
    • Significant ABG closure was achieved with ETC (6.8 dB) and TCM (6.5 dB), but not CWD (2.1 dB).
    • Partial ossicular replacement prostheses (PORP) yielded better postoperative ABG (19.0 dB) than total ossicular replacement prostheses (TORP) (24.1 dB).
    • Both PORP (4.7 dB) and TORP (10.4 dB) showed significant hearing gain.

    Conclusions:

    • Sequential cholesteatoma surgery, particularly ETC and TCM techniques, can achieve excellent postoperative hearing outcomes.
    • An intact posterior canal wall and stapes suprastructure are crucial predictors of superior hearing results.
    • Audiological outcomes are influenced by surgical technique, prosthetic choice, and concurrent middle ear pathology.