Abstract
Objective: 1) To evaluate the relationship between cholesteatoma and the degree of mastoid pneumatization. 2) To assess the relationship between the location of cholesteatoma and mastoid pneumatization.
Method: A prospective analysis on all patients undergoing mastoid exploration for cholesteatoma during 1993-2011 was performed. The degree of mastoid pneumatization and the site of cholesteatoma were recorded. All patients were operated on and graded by the same surgeon. Revision surgery and atticotomy, where pneumatization could not be assessed, were excluded.
Results: A total of 393 (222: male, 171: female) patients underwent surgery for cholesteatoma; 203 were left sided, and 190 were right sided. The mean age of the patients was 37 years (range 6-79). Pneumatization of the mastoid was: sclerotic 23% (90), diploic 16.7% (66), and cellular 60.3% (237, P < .001), respectively. Attico-antral cholesteatoma was present in 88.9% sclerotic, 95.4% diploic, and 91.1% cellular mastoids. Middle ear (ie, sinus tympani, anterior tympanum, posterior tympanum, and Eustachian tube) cholesteatoma was present in 54.4% of sclerotic, 56% of diploic, and 51.9% of cellular mastoids.
Conclusion: In this study, cholesteatoma was most frequently found in relatively well-pneumatized mastoids; this casts doubt on the theory that relatively poor mastoid pneumatization and the subsequent development of cholesteatoma may have a common etiology.
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