Ann Owl Rhinol Laryngol 109:2000 RETROGRADE MASTOIDECTOMY WITH CANAL WALL RECONSTRUCTION: A SINGLE-STAGE TECHNIQUE FOR CHOLESTEATOMA REMOVAL

The goal of this retrospective study was to report the preliminary results of the retrograde mastoidectomy technique with canal wall reconstruction used as a primary treatment method for cholesteatoma. This synthesis of canal wall up (CWU) and canal wall down (CWD) techniques was performed in 70 patients (75 ears; 35 pédiatrie, 40 adult) with an average 45-month follow-up. Surgical intervention involved removal of a portion of the canal wall for exposure and extirpation of the cholesteatoma, followed by reestab-lishment of the canal wall during reconstruction in a single stage. This leaves the mucosa relatively undisturbed and limits the extent of canal wall removal, facilitating mastoid aeration and preservation of anatomy. Recurrent disease occurred in 5 % of cases. The hearing improvement was statistically significant (p <.05), with an average preoperative 4-frequency pure tone average air-bone gap of 27.2 dB improving to 11.5 dB. No patient had a worsening of hearing. The surgery takes less time than traditional techniques, is reproducible and easily taught, and can be universally applied to all cholesteatoma patients as primary treatment. KEY WORDS — canal wall reconstruction, cholesteatoma, ossicular reconstruction, retrograde mastoidectomy