Learning Objectives: The consistent performed and longterm follow-up after cholesteatoma surgery is essential for the evaluation and a prerequisite for a comparison of the surgical results.

Introduction: The aim with the study was to present and compare data from two separate studies of a 6-years follow-up after cholesteatoma surgery in adults and children.

Material and methods: 301 adult- (330 ears) and 57 paediatric patients were operated for cholesteatoma. In all cases an identical one-stage canal-wall down-technique with reconstruction of the middle ear and mastoid obliteration using autologous bone was used. In the adult group 47% had previous surgery, in the paediatric group 7%.

After surgery a standardized protocol for documentation of the intra- and postoperative findings and surgical steps including a sketch and the preoperative audiometric data -pure tone average (PTA) for air- and bone conduction threshold levels (0.5–3kHz) - were registered in the data based follow-up-program. All patients were examined annually after surgery and the surgical and the audiometric data fed into the program 1, 3 and 6 years after surgery.

Results: In the adult group residual disease was found in 3%, in the paediatric group in 5%. The recurrence rate was 10% and 12%. Chain revisions were performed in 19% and 14%. The rate of the postoperative water resistance was 5% and 7%, the postoperative infection rate 3% and 0%.

Long lasting improvement and/or preservation of hearing were obtained in both groups. The pre-and postoperative air conduction hearing levels were 45.8 dB and 35.8 dB in the adult group, in the paediatric group 33 dB and 25.5 dB.

Conclusions: Independent of preoperative middle ear condition, cholesteatoma extent and localization, the used surgical technique provided a long-term improvement of hearing with a low incidence of residual and recurrent disease. No differences in outcome between adult and children were found.