Outcomes of surgery for the prevention of residual and recurrent cholesteatoma

Abstract

We performed posterior wall preservation tympanoplasty for newly treated patients with middle ear cholesteatoma using a one-stage procedure. In advanced cases or in cases with poor mastoid cell development, we chose to remove the posterior wall of the external auditory canal and open the mastoid. To examine the classification of cholesteatoma and the outcome of each procedure, we conducted a retrospective review of the hearing improvement and recurrence rates in 131 patients who underwent initial surgery between January 2013 and December 2020. The hearing improvement rate was comparable to that in previous reports but was poor in patients who received type IV tympanoplasty. The recurrence rate was examined according to the use of endoscopic observation and the anterior tympanotomy technique. The residual recurrence rate increased after the introduction of endoscopy, although the difference was not statistically significant. Postoperative retraction pockets were less common in cases in which anterior tympanotomy was performed.