Postoperative cholesteatoma: are claims for the canal wall down technique justified?

To discover whether removal of the canal wall would reduce the incidence of postoperative cholesteatoma in tympanoplasty, the findings in staged, intact canal wall tympanoplasties were compared with those in staged, modified radical mastoidectomies with cavity obliteration and tympanoplasty. In all, cholesteatoma was considered totally removed at the first operation. The incidence of residual cholesteatoma was not significantly different in either group. It is concluded that staging in tympanoplasty for cholesteatoma is mandatory.