Yıldırım Ahmet BAYAZIT, Süleyman CEBECİ, Recep KARAMERT, Nagihan GÜLHAN, Mehmet Ekrem ZORLU, Mehmet DÜZLÜ, Mehmet Birol UĞUR, Ayşe İRİZ, Fakih Cihat ERAVCI, Hakan TUTAR

Canal wall down versus canal wall up surgeries in the treatment of middle ear cholesteatoma

Background/aim: To compare outcomes of canal wall up (CWU) and canal wall down (CWD) techniques in the treatment of middleear cholesteatoma.Materials and methods: Medical records of 76 patients who had a primary surgery due to middle ear cholesteatoma between July 2015and November 2017 were reviewed retrospectively. Hearing thresholds, speech discrimination scores (SDS), recurrences, and revisionsurgeries of CWU and CWD surgeries were compared.Results: Of 76 cholesteatoma cases, 40 (52.6%) had a CWU and 36 (47.4%) had a CWD operation. Postoperatively, the mean airconduction thresholds were significantly better in CWU compared to CWD surgeries (P = 0.016). The presence of the stapes and thetype of reconstruction material used did not have a significant effect on auditory success rates (P = 0.342 and P = 0.905, respectively).Auditory success was affected by the status of the middle ear mucosa as well. The recurrence and revision rates did not differ betweenthe surgical techniques (P > 0.05).Conclusion: Status of the middle ear mucosa and external auditory canal are important factors affecting the outcomes in cholesteatoma.Instead of a CWD surgery, a CWU surgery seems applicable in cases of cholesteatoma when the bone in the external auditory canal isnot eroded by the disease.

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