Cholesteatoma surgery with the canal wall up technique combined with mastoid obliteration: results from primary surgery in 230 consecutive cases

Abstract

Objective: To evaluate the canal wall up (CWU) technique combined with mastoid obliteration used in cholesteatoma surgery from the aspects of safety and function.

Study design: Retrospective chart review. Information was extracted from a medical database and complementary data from patient files and audiograms were collected and recorded retrospectively.

Setting: A tertiary-stage hospital and a secondary-stage hospital. Surgeons of various levels of experience.

Method: Data from a consecutive group of 230 primary operations for cholesteatoma surgery using CWU with obliteration employing the combined approach tympanoplasty (CAT) technique, from January 1994 to December 2009 were analyzed.

Results: In 90% of the ears, the anatomy was normalized with an intact ear drum.

The frequency of residual cholesteatoma was 1% and the frequency of recurrent cholesteatoma 8%. Hearing was improved one year postoperatively and remained improved three years postoperatively. No patient suffered a total hearing loss.

Conclusions: CWU procedure comprising CAT with obliteration of the mastoid is a safe surgical method with a low frequency of residual and recurrent disease and a good hearing preservation.

Chinese abstract

目的：从安全和功能角度评价用于胆脂瘤手术的 胆管壁术（CWU）联合乳突消除术的疗效。

研究设计：回顾性图表评价。从医学数据库中提取资料, 收集并记录来自患者档案和听力图的补充资料。

设置：一所三级医院和一所二级医院。各级经验的外科医生。

方法：分析了1994年1月至2009年12月间, 采用联合鼓室成形（CAT）技术, 使用胆管壁术联合乳突消除术对 230例连续患者进行的胆总管结石手术的资料。

结果：在90％的耳朵中, 解剖结构正常化了, 耳鼓完整。胆脂瘤残留率1％, 复发胆脂瘤率8％。听力在术后一年有所改善, 术后三年仍保持良好。听力完全损失的病人无。

结论：包括CAT在内的消除乳突的CWU手术是一种安全的手术方式, 残留复发率低, 听力保存良好。

Keywords:

• cholesteatoma
• canal wall up
• combined approach tympanoplasty
• obliteration
• residual

Disclosure statement

The authors report no conflicts of interest.