[Cholesteatoma surgery. Cavity repair. Personal technique]

We report the cases of 158 ears treated surgically for cholesteatoma in the past 6 years. Early diagnosis makes more conservative surgery possible (retraction pockets, reconstructive techniques). However, many interventions still produce large cavities that must be repaired. The use of autologous and heterologous materials in the reduction of these large cavities has been described. Failure of these filling techniques as a result of resorption or intolerance in some cases leads to chronic ear discharge or residual cholesteatomatous growth between the cavity and the filling tissue which requires reoperation. We describe our surgical technique, which aims to produce a wide, well-ventilated outer ear canal with adequate drainage of epithelial debris. A meatal skin flap is created, which is followed by a wide meatoplasty and the creation of a musculoaponeurotic flap using this meatal skin flap as pedicle. The musculoaponeurotic flap is sutured to the subcutaneous tissue and to the temporal muscle. This produces a wide external ear canal when the meatal skin flap is moved to repair the cavity.