Surgical Results of Canalplasty Using a Pedicled Periosteal Flap for External Auditory Canal Cholesteatoma.

OBJECTIVE

We evaluated the outcomes of canalplasty for external auditory canal cholesteatoma (EACC) using an inferior-pedicled periosteal flap to cover the eradicated diseased bone.

STUDY DESIGN

Retrospective chart review.

SETTING

Tertiary referral center.

PATIENTS

Thirty-one ears in 30 patients surgically treated for stages III and IV primary EACC.

INTERVENTION

Canalplasty using an inferior-pedicled periosteal flap with or without tympanoplasty.

MAIN OUTCOME MEASURES

Disease recurrence, hearing, and clinical factors influencing the time taken to achieve complete epithelization of the external auditory canal.

RESULTS

The 31 ears with EACC required 2 to 40 weeks (mean, 7.8 wk; median, 4 wk) to achieve complete epithelization. After epithelization, 84% of the ears became self-cleaning ear canals without any local treatment. Two patients with renal dysfunction experienced recurrence of EACC in the anterior-superior bony canal wall and needed additional treatment. Younger patients took a significantly shorter time to achieve epithelization than older patients ( p < 0.001). Patients with renal dysfunction tended to need longer periods for epithelization than those without renal dysfunction ( p = 0.092).

CONCLUSION

Canalplasty for stages III and IV EACC using an inferior-pedicled periosteal flap achieved good postoperative results, with 86% of ears becoming self-cleaning ear canals in a short healing time. Special attention must be paid to the patients with renal dysfunction to create a pedicled flap of sufficient size to cover the bone and maintain a good blood supply.