A Postimplant Cholesteatoma after Modified Radical Mastoidectomy

Abstract

A postimplant cholesteatoma is one of surgical complications of cochlear implantation. Hoffman and Cohen (1995) reported that only one out of 172 (0.58%) patients developed a postimplant cholesteatoma. We experienced a case of postimplant cholesteatoma after the modified radical mastoidectomy. Case: A 61-year-old man underwent left modified radical tympanoplasty with mastoidectomy for middle ear cholesteatoma at another hospital 40 years ago. We performed right open type tympanoplasty for right cholesteatoma, and at that time there was no recurrent cholesteatoma on the left side. He had already lost the sensorineural hearing in both ears. After three-year-observation with no recurrence of cholesteatoma in both ears, the patient underwent a left cochlear implantation with a Nucleus-24 channel device. After 1 year, we found new lesion of cholesteatoma in the left attic, and removed it by transcanal approach. There has been no recurrence of cholesteatoma for 12 years. Conclusion: In long-standing middle ear problems, when we perform cochlear implantation, even though there is good aeration of the middle ear and an intact tympanic membrane, we need to adequately reflect on the area which should be obliterated.