Atticotomy with reconstruction for limited cholesteatoma.

Several authors have confirmed that it is entirely reasonable to perform a one-stage atticotomy for attic cholesteatomas which are limited in size. Over a period of 10 years, 195 primary procedures were performed for cholesteatoma, and, out of this total, 65 were operated on by an established technique of cartilage repair. In this group of a limited atticotomy there were only two recurrences (3%) and so the technique is considered reliable and, furthermore, using the author's modification, there is no need to dissect out perichondrial flaps. It is recommended that attic cholesteatomas are operated on while they are as small as possible--no damage to the hearing occurred in 63 (96.9%) of the ears in this series--as the results of ossicular repair in ears damaged by cholesteatoma are unpredictable, especially when there is eustachian tube dysfunction.