The closed technique is the treatment of choice for middle ear cholesteatoma in the opinion of the author. Several interventions may be required. At the onset, the purpose of the systematic second stage procedure was to verify the absence of any residual cholesteatoma. Experience has shown that the interest of this second intervention lies equally in the opportunity to observe the evolution of the otitis disease process, and the tubal status and in the possibility of restoring transmission under optimal conditions, thanks in particular to the utilization of thick silastic sheeting. This technique necessitates, however, a long-term follow-up. On occasion, a third intervention may be required. Despite the iterative nature of this surgery, it should be considered as a form of a logical progression offering the best chances of a successful anatomic and functional outcome for the patient.

Adolescent↗

PubMed1993

Secretory otitis media (glue ear).

Explore the source record for details and available documents.

Endoscopy↗

PubMed1991

[Ossiculoplasty: evaluation and perspectives].

Numerous techniques exist for the reconstruction of the ossicular chain. Selection and methods of utilization of the various methods are described. Our preference has been either autograft or allograft ossicular transposition. Analysis of causes for failure and methods to correct them are studied. Difficulties in availability, the risk of transmission of viral diseases, the possibility of long term osseous resorption and practical considerations have led us to use synthetic materials. Hydroxylapatite seems at present to offer the most promising perspectives.

Bone Transplantation↗

PubMed1990

[The contralateral ear in cholesteatoma].

Cholesteatoma of the middle ear is bilateral in 10% of cases. Depending upon the ethnical characteristics or socio-economic levels, the frequency of cholesteatoma for a normal population varies from 1 in a 1,000 to 1 in 10,000. So, it becomes evident that the controlateral ear of cholesteatoma has to be considered at risk. The chances of seeing a cholesteatoma develop and particularly of observing the evolutionary stages are multiplied by 100 or 1,000! This report concerns the results of systematic examination of controlateral ear of 200 consecutive cholesteatomas, using binocular microscope and routine otoscopic photography. Eardrum was normal for 1/3 cases only. Modifications of the aspect of the tympanum related with active or sequellar lesions chronic otitis have been observed in all other cases. This finding leads us to the conclusion that cholesteatoma of the middle ear is related in the great majority of cases with the chronicle ear disease. Tubal insufficiency is of prime importance if we consider the high incidence of retractions pockets. Papillary invagination at the level of Shrapnell membrane is induced by chronical inflam-mation. Epithelial migration from the edges of a perforation is rare and only accidental. Clinical evaluation of the condition of the controlateral ear may also give indications about the background, the eustachian tube function and help for the choice of surgical technique radical or conservative.

Adult↗

PubMed1988