[Functional surgery of cholesteatoma. I. Closed techniques]

A review was made of 138 ears treated with walled-up canal tympanoplasty for chronic otitis media with cholesteatoma. In 66.7% of the ears, two-stage operations were performed. Cholesteatomas were located in the attic (72.5%), mesotympanum (42.8%), antrum (39.1%), and mastoid (11.6%). The most common lesion of the ossicular chain was incus necrosis (61.6%). Total ossicular replacement prosthesis (TORP) (56.5%), partial ossicular replacement prosthesis (PORP) (21.7%), mastoid cortical bone autograft (13%), and incus autograft (8.7%) were used to reconstruct the ossicular chain. After three years, 56.5% of the operated cars were free of complications. The rest had the following complications: recurrence of cholesteatoma (17.4%), perforation of the neotympanum (12.5%), prosthesis extrusion (9.4%), and episodes of otorrhea (4.2%). The best functional results were obtained with autografts (cortical and incus) and TORP.