Results in resident cholesteatoma surgery: a review of 85 cases

A review of all patients with cholesteatoma operated on by the residents of the New York Eye and Ear Infirmary under the attending supervision of the Otology Service between 1980 and 1984 was done. Of 130 resident cases, 85 had documented follow-up 1 year or longer and were included in the study. Recurrence rates were 18% with canal wall down (CWD) and 43% with canal wall up (CWU) techniques. Considering other forms of failure (such as precholesteatoma, tympanic membrane perforation, and chronic infection), overall failure rates were 33% (CWD) compared with 82% (CWU). Cholesteatoma recurrence failure rates were higher in patients under the age of 20 (33%) than over the age of 20 (19%). Overall failure rates were 61% and 37% for younger and older patients, respectively. Due to the high failure rate with canal wall up techniques in resident hands, it is recommended that resident service cases be treated with canal wall down technique, especially in the younger age group.