Evaluation of factors that affect the technique to be used in cholesteatoma surgery

OBJECTIVES: We investigated factors that affect the technique to be used in cholesteatoma surgery. PATIENTS AND METHODS: The study included 186 patients who underwent surgery for suppurative chronic otitis media with cholesteatoma. Open technique (group A) was used in 143 patients, and closed technique (group B) was used in 43 patients. The two groups were compared with respect to medical (age, sex, hearing loss, mastoid pneumatization, site of cholesteatoma, complications) and paramedical (education level, postoperative patient compliance, health insurance, the season at the time of operation) factors. RESULTS: Medical factors that differed significantly between the two groups included the degree of hearing loss, site of cholesteatoma, and presence of complications. The only significant difference was in education level among the paramedical factors. A great majority of patients with a hearing loss above 60 dB were in group A. Cholesteatoma was localized in the middle ear and attic in 10 patients, and in the antrum and/or mastoid cells in 133 patients in group A, compared to 37 and six patients in group B, respectively. All the patients (n=34) who had chronic otitis media complications associated with cholesteatoma were in group A. CONCLUSION: Our findings suggest that selection of the technique for cholesteatoma surgery depends on more than one factor.