Long-Term Results with Operated Sinus Tympani Retraction Cholesteatoma

Abstract

OBJECTIVES: Utilizing an endaural approach, we described the surgical treatment of 29 cases of sinus tympani retraction cholesteatoma in 1996. The purpose of this paper is to provide long-term results in this group of patients. STUDY DESIGN AND SETTING: A retrospective chart analysis of 29 previously reported patients was undertaken in an effort to identify hearing results and the risk of cholesteatoma recurrence following sinus tympani retraction surgery. RESULTS: The follow-up period ranged from 9 to 16 years (mean of 13.2 years). Speech discrimination (SD) and conductive hearing (CH) decline occurred in 23 of 28 patients, but only on the average of 5.6% and 9 dB throughout the speech frequencies, respectively. Speech discrimination and conductive hearing improved in 5 of 28 patients; one patient was lost to follow-up. One patient developed a recurrent cholesteatoma requiring a canal wall—down mastoidectomy. CONCLUSIONS: The endaural approach for sinus tympani cholesteatoma provided stable hearing in most of the patients in this series. One cholesteatoma recurrence required conversion to a canal wall—down mastoidectomy. This developed in a noncompliant patient, whose pars tensa retraction deepened as a result of failure to have his ventilation tube replaced. Semiannual office visits are recommended in patients who undergo this otologic approach for sinus tympani cholesteatoma.