Mastoidectomy for acquired cholesteatoma: Follow‐Up to 20 years.

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Abstract
The results of 423 mastoidectomies for acquired cholesteatoma were reanalyzed 6 years after the first analysis. The mastoidectomies were placed into three groups: open‐cavity, 135 modified radical and 37 radical; obliteialvd‐cavity, 60 modified radical and 20 radical in which the mastoid cavities were obliterated with pedicle muscle grafts; and inlacl‐canal‐wall, 69 complete and 102 complete with opening of the facial recess. The following observations were made.1. The cholesteatoma failure rate increased: for the open‐cavity group, from 6% to 7%; obliterated‐cavity group, 16% to 18%; intactcanal‐wall group, 35% to 45%.2. The precholesteatoma (retraction pocket) failure rate in the open‐cavity and obliterated‐cavity groups did not change. In the intact‐canal‐wall group, recurrent cholesteatomas developed in 8 cases initially classified as precholesteatomu failures. In 9 initially classified as successful, retraction pockets developed and 7 of these went on to recurrent cholesteatomas. Consequently, despite the progressive increase in formation of retraction pockets, the overall incidence dropped from 20% to 16%.3. Failure due to chronic or frequent recurrent infection did not change in the open‐cavity and intact‐canal‐wall groups. However, in the obliterated‐cavity group, it increased from 4% to 5%.4. The overall failure rate increased: open‐cavity group, 18% to 19%; obliterated‐cavity group, 29% to 30%; intact‐canal‐wall group, 60% to 66%.

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