p-ISSN 2083-389x   e-ISSN 2084-3127


Factors influencing the success of cholesteatoma surgery: a postoperative review.

Millan Stankovic, Petar Stankovic

JHS 2011; 1(2): OA

DOI: 10.17430/882086


Aim: To review the audiological results of patients surgically treated for cholesteatoma.
Patients and methods: Retrospective study of patients operated for acquired middle ear cholesteatoma during the period 1990-2002 was performed. Total 758 patients were followed during short-term and 611 patients during long-term period. The localization of cholesteatoma was classified as: attic, sinus, or tensa. Closed tympanoplasty was always performed as single procedure of choice on all the children, and reoperation or conversion to open tympanoplasty was made later if needed. Adult patients were treated with single classical canal wall up, or wall down, according to the propagation of disease and condition of middle ear. Preoperative and postoperative air bone gap (ABG), and pure tone average (PTA) were compared.
Results: Hearing improvement (reduction of ABG) amounted 20.0 dB for short-term, and deteriorated to 18.0 dB during long-term analyze for all the patients. Preoperative hearing level was significantly worse for CWD, than for ICW technique. The ABG closure was much better in the group with attic cholesteatoma. Revision operations and bilateral cholesteatoma gave worse total postoperative hearing. Damage of auditory ossicles correlated well with total preoperative and postoperative results.
Conclusion: The audiological results of cholesteatoma surgery are preserved during long-term follow up. Poorer preoperative hearing level, CWD tympanoplasty, bilateral cholesteatoma, and ossicular damage, as well as revision surgery, were associated with reduced gains in hearing with surgical management.

Keywords: Tympanoplasty, Cholesteatoma, pure tone average, air bone gap