Uzavřená a otevřená chirurgiestředoušního cholesteatomu

Occluded and Open Surgery of Middle Ear Cholesteatoma

Based on data in literature the paper evaluates the extent of risk for the developmentof residual and relapsing cholesteatoma after a primary therapy of middle ear cholesteatoma by theoccluded technique. This kind of technique has not decreased the risk over the last 40 years. Incontrast, the higher frequency of middle ear cholesteatoma with prevailing defect of mesotympanum,with developed pneumatization and dysfunctional Eustachian tube, rather increased. Thetechnique does not exclude the need of subsequent otology care and even does not secure significantlybetter results than other type of surgical treatment. It does not pose a greater risk from thepoint of view of complications, though. The risk of second or further cholesteatoma is generally onthe average over 40%, the rate of re-operations is even greater. The risk, although lower, is alsopresent in the open operations, which are accompanied by a higher frequency of inflammations oftrepanation cavity especially in the child age.

Key words:
middle ear cholesteatoma, therapy, occluded technique, surgical treatment.