[Therapeutic difficulties encountered in association with cholesteatomas (author's transl)]

The authors stress the frequency of recurrences of cholesteatoma or of epidermosis, not in the attico-antro-mastoid cavities, but in the drum and more particularly the region of the sinus tympani. The authors feel that the frequency of recurrences in the large sinus tympani is explained by the impossibility of exploring this region under direct vision in either closed or even open techniques. It is for this reason that they suggest a sub-labyrithine intersinuso-facial approach which makes it possible to explore the sinus tympani under direct vision. In the child, the best method for the prevention of recurrences and to obtain drying is felt to be the combination of maximum lowering of the wall of the facial and a meato-conchal plasty.