چكيده لاتين :
Background: During last decades, many otologists attempted
to make a long standing dry ear, resulting in better hearing
after cholesteatoma surgery. This study evaluated the prognosis
of two common methods of cholesteatoma ear surgery considering
ten years follow-up.
Methods: This retrospective analysis was done using medical
records of 108 adult patients with cholesteatoma. After ten
years of operation, in these patients we compared the results
of the two major trends of canal wall up (CWU) and canal
wall down (CWD).
Results: Among these patients, 72 (67%) and 36 (33%) underwent
the CWD and CWU method respectively. During follow-
up, 8% of patients with CWD and 21% of those with
CWU had undergone at least one revision operations. Ten yrs
after primary surgery, 93% of the ears were dry, 90% with
intact tympanic membrane, with 42% of CWD and 52% of
CWU groups having fair hearing. One deaf individual was
found in each group. The recurrence rate was reported in 6%
of CWD and 17% CWU patients, and independent of the size
of cholesteatoma, mastoid status or foot plate erosion. The
major predisposing factors for recurrence were retraction and
discharge, especially in combination. Intact tympanic membrane
was more frequent in CWD group, although there was
no significant difference between the recurrence rates of these
two groups.
Conclusion: The result ofthis study indicated a need for improving
surgical techniques in order to lower the recurrence rate and
improvementof hearing, especiallywith the help of endoscopes
