[The application of cortical bone avoiding retraction pockets in case of cholesteatoma operations (author's transl)]

All those different operation methods thought for the preservation and reconstruction of the posterior canal wall in the last decennium show us in a high degree the extension of the problems. We ourselves have--after first enthusiasm for the "temporary meatotomy"--later preferred the "combined-approach-technic". Hereby the care to avoid retraction pockets in the lateral attic wall stood ahead. After the first use of muscle, connective tissue and fascia, later on the lyophilised dura and the cartilage, we today prefer cortical bone of the planum mastoideum. This is thought to be the original material for this purpose not having been in touch with the cholesteatoma or the matrix and guarantees by the accompanied periosterm a seamless pass over to the remaining canal wall. Also an additional usage of lyophilised dura--situated bricklike along the separating line--avoids a new retraction. In case of the slightest suspection for the possibility of a residual cholesteatoma a "Second look" operation should be carried out one year after the first operation. A further control should follow after 5 years.