[Tympanoplasty in cholesteatoma otitis media with normal hearing]

Thirteen cholesteatomas, with hearing within 20dB, were operated on from 1985 to 1992. Their mean age was 22.1 years, and the mean follow-up period 1.8 years. Eleven cases were pars flaccid type, and 2 cases pars tensa type. Tympanoplasties were performed by the canal down method (4 cases), the canal up method (3 cases), both transmeatal atticotomy and scutumplasty (4 cases) and both the canal down method and mastoid obliteration (2 cases). Postoperative hearing results of three averaged speech frequencies were within 20dB in 11 cases and between 20 and 30dB in 2 cases. No recurrent cholesteatoma or extrusion of columella occurred during the follow-up period. One of the cases operated on by the canal down method showed postoperative mastoid cavity problems, and one of the cases operated on by the canal up method showed retraction of the pars flaccida. These findings prompted us to operate on cholesteatoma cases with normal hearing and to recommend tympanoplasty with transmeatal atticotomy and scutumplasty.