[Cholesteatoma of the ear. Experience with an eclectic therapeutic attitude]

In the light of 702 cases of cholesteatoma seen over a 20 year period, the authors report the experience of a hospital team based upon analysis of the last 517 cases. 322 patients were treated by a conservative attitude to the bony meatus, including 120 undergoing routine revision between 14 and 24 months. 195 cases were treated by an open technique, either primarily or following massive recurrences despite the use of closed techniques. In 33% of cases, patients had already undergone at least a tympanoplasty. The authors discuss the indications of the treatment of cholesteatoma. Each patient must be considered as an individual case and whilst our preference would be for conservation of the bony meatus, certain anatomical and functional conditions make a so-called open technique necessary in 1/3 of cases.