Abstract Otology 2000 B15-4

Kee Hyun Park MD, Ph.D.

Department of Otolaryngology Ajou University School of Medicine ROK-Suwon

The goal of the surgery for cholesteatoma in the middle ear is to provide the patient with a dry, safe ear and good hearing. An additional goal is not only to maintain a normal ear canal contour, that is, avoiding cavity problems, but also to minimize the need for long-term care of the operated ear. There are some attic cholesteatomas in which the middle ear is aerated and free of significant disease. So attic cholesteatoma surgery is thought to be reconstructive rather than destructive and it can be a prophylactic operation. In this study, I attempted to describe prerequisites for atticoplasty for attic cholesteatoma, which is one of the reconstructive surgical procedures for the middle ear. During the last 10 years, I managed surgically about 200 cases of attic cholesteatoma, among which there were 30 cases of atticoplasty, about 30 cases of mastoid obliteration, about 30 cases of intact canal wall mastoidectomy, and about 110 cases of open cavity mastoidectomy. I analysed 30 cases of atticoplasty with special reference to period of postoperative care and hearing results, as compared to cases with mastoid obliteration and open cavity mastoidectomy. I concluded that the prerequisites for atticoplasty during surgery for attic cholesteatoma were as follows; (1)no otorrhea at the time of operation; (2)intact posterior mesotympanum in the operation field; and (3) removal of incus and malleus head during the operation.