Learning Objectives:

Introduction: Modified Bondy technique in indicated in patients with epitympanic cholesteatoma, good hearing and intact pars tensa and ossicular chain. It permits to eradicate the desease with a single stage procedure. This presentation evaluates the short- (6 mo) and long-term (5 yr) outcomes of modified Bondy technique, with particular reference to hearing results.

Methods: Four hundred eight ears were operated on, using a modified Bondy technique between 1983 and 2013. All patients had primary acquired epitympanic cholesteatomas with intact pars tensa and intact ossicular chain in normal or good-hearing ear. Preoperative audiometric results revealed a mean air conduction pure-tone average of 27.7 ± 9.6 dB (range, 10–65 dB) and a mean bone conduction pure-tone average of 14.2 ± 6.4 dB (range, 5–50 dB). The mean preoperative air-bone gap was 13.5 ± 6.7 dB (range, 0–25 dB). The average length of follow-up was 7.8 years (range, 5–16 yr).

Results: There was no recurrent cholesteatoma in the present series. A pearl-like residual cholesteatoma was found in the cavity in 7.4% of ears; 0.8% developed stenosis of meatoplasty, 1.3% exhibited retraction pockets extending to the attic. Postoperative discharging ear was observed in 3% of cases and was successfully treated with topical drops. At the long-term follow-up, the air-bone gap was unchanged or improved from the preoperative level in 88% of cases. The mean postoperative short- and long-term air-bone gaps were 14.6 ± 8.5 dB (range, 0–55 dB) and 14.1 ± 8.2 dB (range, 0–50 dB), respectively. Postoperative high-frequency sensorineural hearing loss was observed in 1.7%. No dead ears were encountered postoperatively.

Conclusion: A modified Bondy operation is recommended in selected cases of epitympanic cholesteatoma in normal or good-hearing ear with an intact pars tensa and ossicular chain. Modified Bondy technique ensures complete eradication of disease while preserving a good preoperative hearing in 1-stage operation.