Long-term Outcomes of Treating Middle Ear Cholesteatoma with Intact-Canal Wall and Scute Repairing Techniques

Abstract

Objectives:

Assess the long-term outcomes of treating middle ear cholesteatoma with multiple techniques including intact-canal wall and scute repairing techniques.

Methods:

One hundred thirteen patients had been treated between 2001 and 2006. Multiple techniques including harvesting bone chips with air drill, sculpting of autologous bone grafts, chorda tympani nerve tightening prosthesis, preventing adhesion with hyaluronic acid ester membrane, lesion cleaning, reconstruction of ear canal wall, re-gasification of attic and/or mastoid cavity, and early catheterization of the Eustachian tube were performed.

Results:

One hundred twelve ears only received the operation once, and the preoperative air bone conduction gap (ABG) was 33.61 ± 12.35 dB, which was significantly higher than postoperative ABG (13.58 ± 9.27 Db, t = 18.35, P < .01 [G1]). Success rate of the treatment was 85.48% (106/124), and the effective rate was 47.58% (59/124). Significant improvement in the bone conduction threshold was also found (17.3 ± 13 vs 15.15 ± 11.79 dB, t = 4.77, P < .01). Twenty-one ears (16.93%) had increased bone conduction, 61 ears (49.19%) had decreased bone conduction, and the other 42 ears (33.87) had no change in the bone conduction. The long-term success rate was 83.87% (104/124), and the effective rate was 38.7% (48/124). No significant difference was found in the GAP, GAP change, and AC between the values measured at the last follow-up of the long- and short-term follow-up study (P > .05).

Conclusions:

Treating middle ear cholesteatoma with intact-canal wall and scute repairing techniques is safe. These surgical procedures involve low relapse rate, and treating patients with relapsed cholesteatoma with these procedures could also result in good outcomes.