Abstract
At the planning cholesteatoma surgery, a choice of procedure is difficult in patients with adhesions to the dura mater or sigmoid sinus. Our patient was a 16-year-old girl with cholesteatoma widely adherent to the dura of the posterior cranial fossa and the sigmoid sinus, and difficulty in resecting of the lesion was anticipated. Considering the patient's age and the good pneumatization of her mastoid cavity, we first attempted total resection of the cholesteatoma epithelium by canal wall up tympanoplasty. As a result, the cholesteatoma epithelium was successfully separated and removed from the posterior cranial fossa dura and the sigmoid sinus. In view of the patient's age and a possibility of residual cholesteatoma, we performed staged surgery. At the second-look operation, no residual cholesteatoma was identified, but the mastoid cavity was filled with granulation tissue. Accordingly, mastoid obliteration with bone putty was performed. We collected answers from the audience to our questions regarding this case and compared them with the actual operative procedure.
