Hearing after surgery for cholesteatoma using various techniques.

The late results in 740 patients with cholesteatoma subjected to one-stage canal wall down mastoidectomy (262 patients), modified canal wall up mastoidectomy (324 patients), and tympanoplasty without mastoidectomy (154 patients) were analyzed with regard to hearing and the condition of the drum. Mean observation time was 9.3 years, range 3-21 years. Postoperative hearing (air bone gap and pure tone average) and as hearing at the last evaluation was significantly better in the canal wall up group, than in the canal wall down group, but also the preoperative hearing was better in the canal wall up group. The postoperative hearing was best in the group with tympanoplasty only without mastoidectomy. It is concluded that no single method is optimal in all cases of cholesteatoma and that cholesteatoma surgery should be individualized.