[Controversy--open technic--closed technic. Critical review of the literature and our personal experience]

The authors have made a comparative study of the functional and auditory results, as well as an appreciation of the eradication of disease, in 64 patients having undergone open technic surgery for cholesteatoma (66 operations) and in 136 patients treated by closed technic (197 operations). The closed technic would appear to be the one of choice as regards the functional hearing results, most particularly in cases of absence of the stapedial crura. Concerning eradication of middle-ear disease, they believe there to be reason for a somewhat less categorical position towards the accepted fact of the semi-open technic (modified radical mastoidectomy) being strikingly safer than the closed technic. They deplore the difficulty of being unable validly to compare the published results obtained by various authors, due to the diversity of the surgical technics and a lack of uniformity in evaluating and presenting the results.