Between January 1990 and August 2007, 42 patients who underwent a revision tympanomastoidectomy for a recurred cholesteatoma were analyzed retrospectively. All patients initially underwent the canal wall up procedure. Recurrence rates, audiologic outcomes, and the extent of recurrent/residual cholesteatoma were investigated, and the revision surgical methods were compared.
The mean follow-up duration was 10 years (range, 13 months–15.6 years). The CWD procedure was performed in 29 (69 % ) patients with a recurred cholesteatoma and the CWU procedure in 13 (31 % ) as a first revision procedure. CWD surgeries were performed in more severe cases. A second revision surgery was required in five (12 % ) patients. Extended cholesteatoma recurrences were observed even among cases with a lower disease stage at the time of primary surgery. The second recurrence rate was significantly higher in the CWU group than the CWD group (p = 0.026). The 8-year disease-free follow-up rate in the CWD group was significantly higher than the CWU group (p = 0.002). Postoperative AB gap closure was significantly better in the CWU group than CWD group (p = 0.001).
The CWD procedure is a safer and more successful method for controlling recurrent cholesteatoma. Thus, surgeons should not be hesitant to perform the CWD procedures for revision cases.