Outcome of residual cholesteatoma and hearing in mastoid surgery.

OBJECTIVE

To review 12 years of the senior author's experience with mastoid surgery for cholesteatoma.

DESIGN

Retrospective review.

SETTING

Northwestern University Medical School.

METHODS

Available records included 97 mastoid procedures for cholesteatoma: 54 with intact canal-wall and 43 canal-wall-down.

MAIN OUTCOME MEASURES

Residual cholesteatoma, pure-tone audiometry, and speech audiometry were compared for both groups.

RESULTS

Residual disease rate was 11 of 54 (20%) for intact canal-wall procedures and 2 of 43 (5%) for canal-wall-down procedures. Average follow-up was 2 years. Hearing was preserved postoperatively, and neither procedure demonstrated clear superiority in this regard.

CONCLUSION

While canal-wall-down mastoidectomy provides a lower residual disease rate with equal hearing outcome, the role of intact wall mastoidectomy remains a viable choice in certain clinical situations.