Canal-wall-down tympanoplasty with mastoidectomy for advanced cholesteatoma

Objective: The objective of this study was to review 8.5 years of the senio r author's experience with canal-wall-down mastoid surgery for extensive ch olesteatoma with high-grade atelectasis and severely destructed ossicles. Design: A retrospective review was conducted. Setting: The setting was a tertiary care medical centre. Methods: Available records consulted included 104 canal-wall-down mastoidec tomy for advanced-stage cholesteatomas between July 1984 and December 1992. Main Outcome Measures: Recurrence, hearing results, and dry ear rate were a nalyzed. Results: The recurrence rate was 4 of 104 (3.8%), and 9.6% of subjects suff ered from recurrent otorrhea. Thirty-seven of 104 (35.6%) achieved the clos ure of air-bone gap within 20 dB. The availability of stapes suprastructure influenced the postoperative hearing level significantly (p < .001). Conclusion: Even in treating advanced cholesteatoma, canal-wall-down mastoi dectomy provides a low recurrence rate, establishes a high dry ear rate, an d preserves adequate hearing when the stapes suprastructure is available fo r reconstruction.