Complications associated with the surgical treatment of cholesteatoma.

The surgical complications associated with a cholesteatoma are predictable preoperatively depending upon the location of a cholesteatoma. If the patient has an attic cholesteatoma the surgeon can anticipate postoperatively a dry ear, minimal chance of a persistent or recurrent cholesteatoma, a satisfactory hearing restoration, and, although a mastoidectomy is usually necessary, the size of the mastoid cavity in an adult can be extremely small. If a patient has a middle ear cholesteatoma the surgeon can anticipate postoperatively a relatively high incidence of moist ears, persistent or recurrent cholesteatoma, and an unsatisfactory hearing result. However, rarely will the creation of a mastoid cavity be necessary as rarely will mastoidectomy be required. Although most of the children "before puberty" in the study had middle ear cholesteatomas, all children, regardless of the location of cholesteatoma, had a higher incidence of surgical failure than did adults.