Mastoidectomy For Cholesteatoma: A Ten Years review

Abstract

Objective: To evaluate our experience in treating cholesteatoma surgically to compare the results with published ones and lo draw conclusions which may improve or modify our surgical technique. Methods: Between 19S5 and 1994, 135 files of patients who underwent mastoidectomy as treatment of cholesteatoma were reviewed . Personal data and radiological, audiologica., surgical technique and follow-up results were captured and analyzed. Follow-up period ranged from 0 to 8 years. Results: TI,ere were 135 patients, 96 males and 39 females with an age range of 2-61. The main symptoms were otor- rhoea, hearing loss, tinnitus and vertigo. Fourteen had mastoid abscesses, three facial pals.es, three dead ears and three positive fistulae. The majority were attic disease with polyp formation. Canal Wall Down Mastoidectomy (CWDM) was performed in 93.6% and Canal Wall Up Mastoidectomy (CWUM) in 6.4%. In the group w.th CWDM 42% had con- chomeatoplasty. 31 soft tissue meatoplasty and 34% with no operative detail. Only 100 ears with CWDM had more than 6 months follow-up. of these 7% had dry cavities and 24 wet cavities. CWUM was performed in 9 ears, of which 5 had Cholesteatoma. Four of these kept discharging; hence they underwent revision surgery in the form of CWDM. Conclusion: Middle ear cholesteatoma in our community is an extensive, destructive and complicated disease. CWDM results usually in dry and safe ears while CWUM is unsafe. Special attention should be given to the facial nerve during surgery. Adequate meatoplasty is very important to achieve dry ears.