Management of Cholesteatoma

Peter S. Roland


Several areas of controversy persist in the management of cholesteatoma. All these controversies must be evaluated in the light of clearly established treatment goals. The goals for the removal of cholesteatoma are listed succinctly in Table 37-1.

TABLE 37-1

Goals of Surgery for Cholesteatoma

1. To remove all potentially erosive or invasive disease

2. To create a smooth, exteriorized cavity that can be completely cleaned in the office

3. To create a cavity lined with normal skin that tolerates the usual activities of daily living, including swimming

4. To conserve residual hearing

5. To improve hearing, if possible

6. To provide acceptable cosmetics

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