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Outcome of residual cholesteatoma and hearing in mastoid surgery
D Roden1, V F Honrubia, R Wiet
1Department of Otolaryngology/Head and Neck Surgery, Northwestern University Medical School, Chicago, Illinois, USA.
Objective:
To review 12 years of the senior author's experience with mastoid surgery for cholesteatoma.
Design:
Retrospective review.
Setting:
Northwestern University Medical School.
Methods:
Available records included 97 mastoid procedures for cholesteatoma: 54 with intact canal-wall and 43 canal-wall-down.
Main Outcome Measures:
Residual cholesteatoma, pure-tone audiometry, and speech audiometry were compared for both groups.
Results:
Residual disease rate was 11 of 54 (20%) for intact canal-wall procedures and 2 of 43 (5%) for canal-wall-down procedures. Average follow-up was 2 years. Hearing was preserved postoperatively, and neither procedure demonstrated clear superiority in this regard.
Conclusion:
While canal-wall-down mastoidectomy provides a lower residual disease rate with equal hearing outcome, the role of intact wall mastoidectomy remains a viable choice in certain clinical situations.