Objectives/Hypothesis: Compare surgical and audiometric outcomes following canal wall reconstruction (CWR) tympanomastoidectomy used as a primary versus secondary approach for treating cholesteatoma.Study Design: Retrospective. Methods: Patients treated for primary/secondary cholesteatoma from 2006 to 2017 via CWR were included if they had preoperative/postoperative audiograms, detailed operative note(s), and >12 months' follow-up. Patients were stratified by previous surgical history into two groups: primary CWR group (PG) and secondary CWR group (SG). Surgical outcomes measured were prevalence of recidivistic cholesteatoma, canal cholesteatoma, revision rate, and canal wall down (CWD) conversion rates. Secondary outcomes were prevalence of infection, external canal adhesions/stenoses, and retractions. Audiometric outcomes included change in pure-tone average and air-bone gap.Results: We stratified 45 patients/ears into the PG and 26 into the SG. The groups did not significantly differ in age, sex, or smoking status. Overall, median follow-up was 35 months. SG patients had higher rates of cholesteatoma detected at staged surgery than did PG patients (P = .04). However, these patients exhibited lower rates of open revision surgery (4% vs.13%) and a significant improvement in air-bone gap (P = .004). Three PG patients (7%) required conversion to CWD versus zero SG patients. Secondary outcomes were similar. Patients who underwent delayed staging >12 months from CWR had increased rates of recidivism and canal adhesion/stenosis.Conclusions: CWR was effective for treating cholesteatoma as both a primary and secondary surgical approach. SG patients experienced higher rates of recidivism and secondary canal cholesteatoma. PG patients had higher rates of revision surgery. Staging of ears undergoing CWR is important regardless of prior surgical history.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.