Atticotomy, Attic Reconstruction, Tympanoplasty with or Without Ossiculoplasty, Canal Plasty and Cortical Mastoidectomy as Part of Intact Canal Wall Technique for Attic Cholesteatoma.

To evaluate a technique of canal wall up mastoidectomy for limited attic cholesteatoma and to study practical considerations during surgery. Any person undergoing surgery for attic cholesteatoma was thoroughly examined during surgery and decision for doing this canal wall up (CWU) surgery will be taken on operating table. The patients were regularly followed up and microscopic, oto endoscopic and audiological assessments done at regular intervals. Revision surgery was done only if there were signs of recidivism or if ossiculoplasty was planned for second stage or placement of a prosthesis later was considered. Out of 100 cholesteatoma surgeries, 22 cases found suitable for the CWU technique. Only 1 out of 22 patients required revision surgery due to recurrence. Rest of the patients maintained healthy middle ear for more than a year. Prevention of medialisation of attic cartilage piece was found to be very important consideration. The CWU technique is a reliable method of management for limited attic cholesteatoma. Selection of subjects should be very meticulous.