Canal wall-down procedure with soft posterior meatal wall reconstruction in acquired cholesteatoma: focus on postoperative middle ear status*

Tomoyasu Tachibana, Shin Kariya, Yorihisa Orita, Michihiro Nakada, Takuma Makino, Yasutoshi Komatsubara, Yuko Matsuyama, Yuto Naoi, Kazunori Nishizaki

Research output: Contribution to journalArticle

Abstract

Objectives: We reviewed surgical results of canal wall-down tympanoplasty (CWDT) with soft posterior meatal wall reconstruction (SWR) for acquired cholesteatoma (AC), and identified factors associated with surgical outcomes. Methods: Results from 119 ears with AC (pars flaccida, n = 99; pars tensa, n = 20) that underwent CWDT with SWR were retrospectively reviewed. We defined postoperative balloon-like retraction (PBR) with web formation, which needed reoperation to clean accumulated cerumen, as postoperative deep retraction pocket (PDRP). Results: Residual cholesteatoma was found in 11 ears (9.2%). Seven residual cholesteatomas were treated with outpatient operation. Seven ears (5.9%) showed PDRP. A transcanal approach was applied to all PDRPs. Postoperative mastoid reaeration was observed in 57 ears (47.9%). No factors significantly associated with residual cholesteatoma or PDRP were identified. The frequency of postoperative mastoid reaeration was significantly higher among cases with young age (<50 years), stage I cholesteatoma, or type I ossiculoplasty. Conclusion: CWDT with SWR showed low rates of residual cholesteatoma or postoperative deep retraction pocket (PDRP). Most residual cholesteatomas and PDRPs could be dealt with using a minimally invasive procedure. Young age, stage I cholesteatoma, and type I ossiculoplasty were associated with postoperative mastoid reaeration. This procedure seems fully feasible for surgical treatment of AC.

Original languageEnglish
Pages (from-to)695-700
Number of pages6
JournalActa Oto-Laryngologica
Volume138
Issue number8
DOIs
Publication statusPublished - Aug 3 2018

Keywords

  • Acquired cholesteatoma
  • canal wall-down tympanoplasty with soft posterior meatal wall reconstruction
  • postoperative deep retraction pocket
  • residual cholesteatoma
  • surgical outcomes

ASJC Scopus subject areas

  • Otorhinolaryngology

Fingerprint Dive into the research topics of 'Canal wall-down procedure with soft posterior meatal wall reconstruction in acquired cholesteatoma: focus on postoperative middle ear status<sup>*</sup>'. Together they form a unique fingerprint.

  • Cite this