The retraction pocket in the treatment of cholesteatoma

Residual and especially recurrent disease was observed in 124 consecutive patients who had operations for cholesteatomas, with the finding of continuing problems in at least 23% of these patients. Surgical therapy based on the goals of extirpation of the "pseudoneoplasm" of cholesteatoma, restoration of health and function, and prevention of recurrence is the ideal. Results of "single-barreled" regimens do not yet meet these goals. A compromise surgical management regimen is offered. Etiologic implications of the retraction pocket phenomenon are explored and a testable hypothesis offered.