Retrograde mastoidectomy on demand with soft-wall reconstruction of the canal wall in pediatric cholesteatoma: long term results

Abstract

  To evaluate long term results of surgical outcomes of retrograde mastoidectomy when using soft-wall reconstruction of the canal wall in pediatric cholesteatoma by retrospective case review. A total of 25 ears underwent cholesteatoma removal surgery employing soft-wall reconstruction. Average follow-up time was 96.2 months. The incidence of residual and recurrent cholesteatoma, postoperative hearing results (Guidline for Reporting Hearing Results in Middle Ear and Mastoid Surgery, 2010), and the form of reconstructed external canal wall and tympanum were assessed. Residual cholesteatoma was detected in 5 (20%) while recurrent cholesteatoma was occurred in 1 (4%) out of 25 ears. Success rate of the hearing outcome was 96%. The long term forms of the external canal wall were almost favorable without pathological changes. The form looks changed depends on the eustachian tube function and the middle ear pressure. The feature of the unsatisfactory hearing cases was disease extension to the mastoid and the eustachian tube. Retrograde mastoidectomy with soft-wall reconstruction is an effective technique that can be used to lower the recurrence rate of cholesteatoma in the pediatric population and good hearing outcome. However it is possibly difficult to improve hearing that cholesteatoma extent to the mastoid and the eustachian tube because of potential eustachian tube dysfunction.