Abstract
In this study, we examined the data of 136 patients with pars flaccida cholesteatoma and 62 patients with pars tensa cholesteatoma who had undergone initial surgical treatment at Kurume University Hospital between January 2010 and August 2015.
Canal wall up tympanoplasty (CWU) had been selected as the basic procedure, and the defect in the posterior wall of the ear canal was reconstructed with cartilage. Staged surgery was performed in patients with suspected residual presence of cholesteatoma or severe inflammation.
The selected surgical method, the postoperative hearing improvement rate, and the rate of recurrence were examined retrospectively.
Among the patients with pars flaccida cholesteatoma, transcanal atticotomy (TCA) was performed in 10.3%, CWU in 72.8%, and canal wall down tympanoplasty (CWD) in 16.8% of patients.
Among the patients with pars tensa cholesteatoma, TCA was performed in 57.3%, CWU in 29.5%, and CWD in 13.1% of patients.
In the patients with pars flaccida cholesteatoma, the overall hearing improvement rate was 61.5%.
In the patients with pars tensa cholesteatoma, the overall hearing improvement rate was 63.6%.
In the group with pars flaccida cholesteatoma, residual cholesteatoma was observed in 9.6% and relapse/reformation in 7.4% of patients. In the group with pars tensa cholesteatoma, residue was observed in 11.4% and relapse/reformation in 13.1% of patients.
The rates of recurrence were higher than in previous reports, and we believe that staged surgery should have been performed for more cases.
