Cholesteatomas with Attic Perforation Closure during Preoperative Treatment

Abstract

Four cases of cholesteatoma with attic perforation closure during preoperative treatment are reported. Though the tympanic membrane findings after the closure of the perforation appeared similar to those during the healing process of cholesteatoma, we confirmed the presence of cholesteatoma behind the tympanic membrane because of findings before the closure. All cases were treated by intact canal wall tympanoplasty and the cholesteatoma was removed.
The conditions that allow the perforation to close easily are small perforation, difficultly in removing the polyp and localized inflammation in the perforation.
To avoid overlooking a cholesteatoma when the perforation has closed, careful observation and treatment under a microscope from the initial examination is most important.