Long-term Results of Pediatric Cholesteatoma Surgery Using Canal-Wall-Down Approach with Primary Obliteration: 5-Year Observational Study

AbstractTo obtain the best possible results of treatment of acquired cholesteatoma, we made a subdivision of cholesteatoma types into attic and pars tensa cholesteatomas, and subdivided the latter further into tensa retraction cholesteatoma and sinus cholesteatomas. Tensa retraction cholesteatoma is defined as arising from a retraction or perforation of the whole pars tensa, whereas sinus cholesteatoma is defined as arising from a retraction or perforation of the postero-superior part of the tensa. We present the long-term results obtained in tensa retraction cholesteatomas treated with one stage surgery from 1964 to 1980. Median observation time was 9 years, range 2 to 19 years. Sixty-one ears were treated without mastoidectomy, whereas 71 ears had canal wall-up mastoidectomy and 64 ears had canal wall-down mastoidectomy. The total recurrence rate was 13.3 per cent; 17 ears had residual cholesteatoma, and nine ears had recurrent cholesteatoma. The best results were obtained in ears with an intact ossicular chain where mastoidectomy was not performed. In 49 per cent of the cases, the cholesteatoma was confined to the tympanic cavity without reaching the aditus, antrum or mastoid process. About one-third to one-quarter of the ears had tympanoplasty only, with removal of the cholesteatoma through the ear canal.

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Anatomic and Functional Long-Term Results of Canal Wall-Down Mastoidectomy

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348940411301105 ◽

2004 ◽

Vol 113 (11) ◽

pp. 872-876 ◽

Cited By ~ 31

Author(s):

Maria Izabel Kos ◽

Pierre Montandon ◽

Rodrigo Castrillon ◽

Jean-Philippe Guyot

Keyword(s):

Long Term Results ◽

Canal Wall ◽

Canal Wall Down ◽

Canal Wall Down Mastoidectomy

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Obliteration of Radical Cavities and Total Reconstruction Procedure Without Staging After Canal Wall Down Mastoidectomy: Long-term Results

Clinical and Experimental Otorhinolaryngology ◽

10.3342/ceo.2015.8.3.230 ◽

2015 ◽

Vol 8 (3) ◽

pp. 230 ◽

Cited By ~ 4

Author(s):

Shao-Cheng Liu ◽

Chih-Hung Wang ◽

Bor-Rong Huang

Keyword(s):

Long Term Results ◽

Canal Wall ◽

Reconstruction Procedure ◽

Canal Wall Down ◽

Canal Wall Down Mastoidectomy ◽

Total Reconstruction

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Long term results of total ossiculoplasty in pediatric cholesteatoma surgery

The Journal of Laryngology & Otology ◽

10.1017/s0022215116002814 ◽

2016 ◽

Vol 130 (S3) ◽

pp. S59-S59

Author(s):

Francoise Denoyelle ◽

Jerome Nevoux ◽

Pierre Chauvin ◽

Noël Garabédian

Keyword(s):

Long Term Results ◽

Pediatric Cholesteatoma ◽

Cholesteatoma Surgery

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Long-term Results after Surgery of Cholesteatoma with Canal Wall Down (CWD) Mastoidectomy and Bony Obliteration of the Mastoid

10.1055/s-0040-1711293 ◽

2020 ◽

Author(s):

Lars-Uwe Scholtz ◽

I Todt ◽

D Seitz ◽

H Sudhoff

Keyword(s):

Long Term Results ◽

Canal Wall ◽

Canal Wall Down

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Extensive cholesteatoma: long-term results of three surgical techniques

The Journal of Laryngology & Otology ◽

10.1017/s002221510013782x ◽

1997 ◽

Vol 111 (6) ◽

pp. 521-526 ◽

Cited By ~ 43

Author(s):

Mette Nyrop ◽

Per Bonding

Keyword(s):

Surgical Techniques ◽

Long Term Results ◽

Canal Wall ◽

Mastoid Obliteration ◽

Retraction Pocket ◽

One Stage ◽

Canal Wall Down ◽

Canal Wall Up ◽

Long Term Recurrence Rate

AbstractDuring the years 1979–81, three different surgical techniques were used in the treatment of 87 ears with extensive cholesteatoma. All procedures were performed in one stage by the same surgeon. Ten to 13 years after the operations about 70 per cent of ears operated on by the canal wall up technique had developed a new cholesteatoma, which in most cases was recurrent, or a deep retraction pocket. A modification of this technique with mastoid obliteration resulted in a similar failure rate. In contrast, ears operated on by the canal wall down technique (in most cases with mastoid obliteration) had acceptable stability with a long-term recurrence rate of about 15 per cent. Most patients in the canal wall down group had a dry ear without significant cavity problems. Hearing in these patients was as least as good as hearing in patients with a preserved canal wall. We conclude that a meticulous one-stage canal wall down technique in ears with extensive cholesteatoma results in a high percentage of unproblematic, stable ears with satisfactory function. In contrast, if the posteriorcanal wall is preserved, recurrent cholesteatoma is the rule more than the exception.

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