Learning Objectives:

Introduction: Prevention of postoperative recurrent cholesteatoma is one of the important goals in the management of cholesteatoma. Surgery for recurrent cholesteatoma could be rather challenging because of potential tendency towards re-recurrence. Canal wall down tympanoplasty can be a good surgical option with low rate of recurrence, and soft posterior meatal wall reconstruction has a feature of less formation of a narrow-neck retraction pocket after surgery compared to other hard-tissue reconstruction methods (Yamamoto-Fukuda et al, 2009). In order to achieve disease-free and dry ears after surgery on 13 recurrent cholesteatoma cases which we experienced for 3 years, we adopted a canal wall down technique with soft posterior meatal wall reconstruction. We present representative cases and short-term results with mean follow-up period of 23 months.

Study design: Retrospective chart review

Patients: Thirteen cases of recurrent cholesteatoma out of consecutive 388 middle ear surgeries in Keio University Hospital between January 2012 and March 2015 were enrolled. The average age of the cases was 48 years old with a range of 25–76 years. The mean follow-up period was 23 months (ranging from 10 months to 33 months). The operation was 2nd time in 8 cases, 3rd time in 4 cases, and 4th time in 1 case.

Results: Dry ear was achieved in all the cases in average 5.5 months after surgery and no further infection was observed. Postoperative air-bone gaps were less than 40 dB in 5 patients and 20 dB in 4 patients. No re-recurrence was observed during the observation period.

Conclusions: A canal wall down tympanoplasty with soft posterior meatal wall reconstruction for recurrent cholesteatoma provides good short-term results. Longer observation period is needed to confirm the effectiveness of the surgical procedure.