Complications associated with the surgical treatment of cholesteatoma.

The surgical complications associated with a cholesteatoma are predictable preoperatively depending upon the location of a cholesteatoma. If the patient has as attic cholesteatoma the surgeon can anticipate postoperatively a dry ear, minimal chance of persistent or recurrent cholesteatoma, satisfactory hearing restoration, and, although a mastoidectomy is usually necessary, the size of the mastoid cavity in an adult can be extremely small. If a patient has a middle ear cholesteatoma the surgeon can anticipate postoperatively a relatively high incidence of moist ears, persistent or recurrent cholesteatoma, and an unsatisfactory hearing result. However, seldom will the creation of a mastoid cavity be necessary as rarely will mastoidectomy be required. Although most of the children before puberty in the study had middle ear cholesteatomas, all children--regardless of the location of cholesteatoma--had a higher incidence of surgical failure than did the adults.