Surgical outcome of canal wall up procedures with reconstruction versus without reconstruction

الملخص EN

Objective : to compare the surgical outcome of canal wall up procedure with reconstruction versus without reconstruction, considering recidivism, logorrhea and hearing level.

Materials and methods : Fifty two patients with middle ear cholesteatoma were involved in this study.

26 patients were submitted to canal wall up with reconstruction and 26 patients to canal wall up without reconstruction.

Results: cholesteatoma was attic in 32.7 %, atticoantral in 36.5 % and extensive in 30.8 %.

cholesteatoma residual or recurrence was found in 10 patients (19.2 %) during the three years period of follow up.

seven out of them were children, (2 in attic region with reconstruction, 2 in atticoantral with reconstruction and 3 in atticoantral without reconstruction ,one in extensive with reconstruction and 3 in extensive without reconstruction).

Otorrhea in attic was 45.5% in canal wall up with reconstruction and 50% after without reconstruction, in atticoantral was 50 % and 54.4 % in canal wall up with and without reconstruction respectively and in extensive cholesteatoma was 42.9 % after canal up with reconstruction and 44.4 % after without reconstruction.

There was statistically significant hearing improvement (8.91dB) after canal wall up with reconstruction in attic cholesteatoma while decreased by (2dB) after canal up without reconstruction, in atticoantral and extensive cholesteatoma the hearing gain was insignificant.

Conclusions: surgery should be planned according to the site, size of cholesteatoma and age of the patient.

One stage tympanoplasty is not recommended for childhood or for extensive adult cholesteatoma but only for attic cholesteatoma in adult.