Retrograde approach and soft wall reconstruction in surgery for congenital cholesteatoma

Conclusions: A retrograde approach and soft wall reconstruction is thought to be an effective surgical approach for patients with good eustachian tube function and good mastoid development such as in congenital cholesteatoma. Objective: To analyze the usefulness of a retrograde approach and soft wall reconstructive surgical treatment for congenital cholesteatoma. Methods: Data from 24 patients (25 ears in total) who underwent surgical intervention for congenital cholesteatoma at Kanazawa University Hospital between January 2001 and July 2011 were retrospectively reviewed. We had used a retrograde approach for congenital cholesteatomas in which bone is removed as necessary in a retrograde manner from the external auditory canal side. The extent of bone removal was determined according to the location of the cholesteatoma. The posterior walls of the external auditory canals were reconstructed with soft tissue using temporal fascia. Results: Good preoperative mastoid development was identified in 83% of the patients. Postoperative recurrence was seen in 1 of 25 ears. Analysis of pre- and postoperative hearing ability showed significant improvement in both pure tone audiogram air conduction and pure tone audiogram air-bone gaps.