Cholesteatoma returns far more often after 'closed' ear surgery
Ten years of records on 345 operations compare three ways of removing the destructive ear growth.
A cholesteatoma is a skin-lined cyst that grows inside the middle ear and slowly erodes the tiny hearing bones and the bone around them. Surgery is the only cure, but the growth can come back.
Writing in The Ulutas Medical Journal in 2024, two ear, nose and throat surgeons reviewed 345 operations performed at Çukurova University Hospital between 2010 and 2020 with three techniques. 'Closed' canal-wall-up surgery keeps the back wall of the ear canal; the 'open' canal-wall-down and radical operations remove it.
Over an average follow-up of 36 months, 61 patients (17.6%) needed a second operation. The rate differed sharply by technique: 40.4% after canal-wall-up surgery, against 7.4% after canal-wall-down and 10% after radical mastoidectomy.
The authors conclude that the choice of technique strongly shapes the risk of recurrence.
Caveat: the study is retrospective and patients were not assigned to techniques at random, so the differences may partly reflect who received which operation.
Source: Huseyin Keskin et al. Cholesteatoma Surgery With Three Different Methods: A Clinical Study For Recidivism Research. Ulutas Med J 2024. doi:10.5455/umj.20240229070431.
Image: Figure 1 of the article, CC BY-NC 4.0.
