FINDINGS IN REVISION OPERATIONS FOR FAILURES AFTER CHOLESTEATOMA SURGERY

Surgical findings and long-term results of 112 revision operations per formed for failures after cholesteatoma surgery were studied. The indi cation for revision was recurrence of cholesteatoma in 43 percent, per sistent otorrhea in 27 percent, dry reperforation in 10 percent, and u nsatisfactory hearing result in 18 percent. Of the recurrences, 71 per cent were regarded as residual cholesteatomas (i.e., arising from a ch olesteatoma remnant left at the primary operation). Infected unexenter ated mastoid air cells were found in 63 percent of ears reoperated on for persistent discharge. Thus, it is reasonable to conclude that at l east 48 percent of our revisions could have been avoided if the surgeo n had used more skillful and more radical surgical technique when perf orming the primary operation. On the other hand, the persistence of ch olesteatoma and the difficulty of eradicating the disease is highlight ed by the finding that cholesteatoma again recurred in three patients (3%) after the first revision.