Aims and Objectives

There were two aims or objectives in the management of cholesteatoma long before the introduction of tympanoplasty: to obtain a safe ear and, one hoped, a dry ear. These were accomplished by a radical or modified radical mastoidectomy. With the introduction of tympanoplasty during the mid-1950s, a third objective was added: a hearing ear. This also introduced a controversy: how hard do you try to improve the hearing? This led to much controversy unrelated to the manner of management of the mastoid. How hard should you try to improve the hearing? To stage or not to stage?

The aims and objectives of surgery on the ear with cholesteatoma, then, are (1) eliminate the disease: obtain a safe, dry, ear; and (2) restore the function: obtain a good hearing ear.

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