Plugging the mastoid cavity with Palacos R-a new technique to avoid recurrent cholesteatoma

The requisite for the development of recurrent cholesteatoma caused by a retraction pocket is that the retraction takes place through a bottleneck into an otherwise closed cavity. In order to avoid this kind of recurrence either the bottleneck must be removed or the exenterated mastoid cavity must be plugged. This paper refers to an operation technique which was developed 14 years ago and which removes the bottleneck. Since, however, this technique leads in about half of the cases to an open cavity with the well-known disadvantages, we have tried to obliterate the cavity permanently following a posterior tympanotomy. Obliteration is achieved by means of Palacos R, which makes fixed contact with the bone. The technique and details of its application are described.