Investigation into the underlying disease causing an aural polyp is often hampered when the polyp itself obscures the tympanic membrane. This retrospective analysis of 65 patients undergoing aural polypectomy was carried out to identify and predictive factors for underlying cholesteatoma and to determine a correct management stratergy for aural polyps. The duration of symptoms, size of polyp, size of conductive component of hearing loss and bacteriology of otorrhoea were unhelpful as predictors of the underlying disease. Radiological evidence of bony erosion of the mastoid is a useful sign of cholesteatoma when present.

Aural polypectomy resulted in 58.3 per cent of ears becoming inactive. It is proposed that aural polypectomy and histological assessment should be employed as initial treatment with mastoid exploration reserved for those ears thus identified as high risk for cholesteatoma.