Surgery in Cholesteatoma: Ten years Follow-up

Background: during last decades, many otologists attemptedto make a long standing dry ear, resulting in better hearingafter cholesteatoma surgery. this study evaluated the prognosisof two common methods of cholesteatoma ear surgery consideringten years follow-up.methods: this retrospective analysis was done using medicalrecords of 108 adult patients with cholesteatoma. after tenyears of operation, in these patients we compared the resultsof the two major trends of canal wall up (cwu) and canalwall down (cwd).results: among these patients, 72 (67%) and 36 (33%) underwentthe cwd and cwu method respectively. during follow-up, 8% of patients with cwd and 21% of those withcwu had undergone at least one revision operations. ten yrsafter primary surgery, 93% of the ears were dry, 90% withintact tympanic membrane, with 42% of cwd and 52% ofcwu groups having fair hearing. one deaf individual wasfound in each group. the recurrence rate was reported in 6%of cwd and 17% cwu patients, and independent of the sizeof cholesteatoma, mastoid status or foot plate erosion. themajor predisposing factors for recurrence were retraction anddischarge, especially in combination. intact tympanic membranewas more frequent in cwd group, although there wasno significant difference between the recurrence rates of thesetwo groups.conclusion: the result ofthis study indicated a need for improvingsurgical techniques in order to lower the recurrence rate andimprovementof hearing, especiallywith the help of endoscopes