Clinical Evaluation of Middle Ear Cholesteatoma

Abstract

We evaluated hearing improvement of 81 cases who underwent surgical treatment for middle ear cholesteatoma between July 1997 and December 2003. The post-operative follow-up periods were no less than 6 months after final ossicular reconstruction in all cases. We classified surgical results to be successful when the postoperative hearing level met at least one of three conditions: 1) air-bone gap was less than 20 dB,2) hearing levels were above 30 dB, or 3) hearing gain was more than 15 dB according to the guidelines in middle ear and mastoid surgery (Otology Japan 11,2001). In most cases, the canal wall down method with canal reconstruction was employed and autologaus auricular cartilage was used for ossicular reconstruction. The overall success rate was 74% (60 out of 81 cases). Single staged tympanoplasty was performed in 39 cases and the success rate was 69% (27 out of 39 cases). Programmed staged tympanoplasty was performed in 42 cases and the success rate was 78% (33 out of 42 cases). Tympanoplasty type III was most frequently employed for ossicular chain reconstruction and the success rate was 85%.