Management of Cholesteatoma: Status of the Canal Wall

Laryngoscope - Tập 113 Số 3 - Trang 443-448 - 2003
Mark J. Syms1, William M. Luxford2
1Section of Neurotology, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
2House Ear Institute and House Ear Clinic, Los Angeles, California, U.S.A.

Tóm tắt

Abstract

Objective/Hypothesis Management of chronic otitis media with cholesteatoma remains controversial. The purpose of the study is to examine factors associated with the surgical approach to manage cholesteatoma.

Study Design A retrospective review.

Methods A retrospective review was made of all primary cases of mastoid surgery for cholesteatoma performed at an otological center between 1995 and 2000. During the study period, 486 ears underwent surgery for cholesteatoma. Data included procedures performed, location and extent of the disease, residual and recurrent disease, complications, reasons for staging the surgery, and duration of follow‐up.

Results The canal wall remained intact in 68.5% of ears. The majority of the remainder of the patients underwent a canal wall down technique with mastoid obliteration. Residual cholesteatoma was found in 26.9% of second procedures and in 2.7% of third procedures.

Conclusions The majority of patients with cholesteatoma can be adequately managed with a canal intact tympanomastoidectomy with staging. Otolaryngologists should consider a two‐staged procedure as a viable management approach for chronic otitis media with cholesteatoma.

Từ khóa


Tài liệu tham khảo

10.1288/00005537-195608000-00008

10.1017/S0022215100051240

10.1288/00005537-196708000-00018

10.1177/000348947708600405

Sheehy JL, 1982, Cholesteatoma surgery at the otologic medical group: residual and recurrent disease, Am J Otol, 3, 209

10.1177/000348949510400801

Roden D, 1996, Outcome of residual cholesteatoma and hearing in mastoid surgery, J Otolaryngol, 25, 178

Chang C, 2000, Canal‐wall‐down tympanoplasty with mastoidectomy for advances cholesteatoma, J Otolaryngol, 29, 270

Sade J, 1987, Treatment of cholesteatoma, Am J Otol, 8, 524

Cody DTR, 1977, Cholesteatoma: First International Conference, 337

10.1288/00005537-198204000-00007