Learning Objectives:

Introduction: Despite declining prevalence, cholesteatoma remains the most devastating type of chronic otitis media that can affect hearing, balance and facial nerve function. In order to prevent such complications, cholesteatoma requires surgical removal. This study presents the lessons learned from an overview of personal results of a single otologic surgeon after starting in a staff position.

Methods: 183 patients that were operated for cholesteatoma between September 2009 and November 2015 by a single otologist were included in this retrospective evaluation. All patients underwent surgery for cholesteatoma and were followed-up by either MRI DWI (>95%) or a mandatory second look procedure (<5%). In general, a canal wall-up technique with ossicular chain reconstruction was used and in selected cases this was followed by mastoid obliteration with bone dust.

Results: Personal results will be presented on recurrent and residual disease after cholesteatoma surgery. A significant otologic learning curve was seen after evaluation of all cases and this was entirely related to a significant reduction of the percentage recurrent and not residual cholesteatoma. Additional mastoid obliteration leads to a significant reduction of recurrent but not residual disease. No difference was seen in results between pediatric and adult patients.

Conclusion: A strict personal follow-up of surgical results on cholesteatoma surgery identified mastoid obliteration as a key factor to reduce recurrent cholesteatoma.