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Subtotal Petrosectomy in the management of difficult cases of cholesteatoma

Presenting Author: Sampath Chandra Prasad

Published online by Cambridge University Press:  03 June 2016

Sampath Chandra Prasad ,
Valeria Roustan ,
Enrico Piccirillo ,
Annalisa Giannuzzi  and
Mario Sanna
Sampath Chandra Prasad
Affiliation:
Gruppo Otologico
Valeria Roustan
Affiliation:
Gruppo Otologico
Enrico Piccirillo
Affiliation:
Gruppo Otologico
Annalisa Giannuzzi
Affiliation:
Gruppo Otologico
Mario Sanna
Affiliation:
Gruppo Otologico
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Abstract

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Learning Objectives:

Objectives: The purpose of this study was to review the indications for subtotal petrosectomy in difficult cases of cholesteatoma, report our management of complications, as well as review those technical factors that are critical for successful outcomes.

Methods: Patients (n = 240) that underwent subtotal petrosectomy with closure of the external auditory canal and obliteration of the cavity with abdominal fat for various presentations of cholesteatoma were analyzed.

Results: The most frequent indication for subtotal petrosectomy was in recurrent disease, previous radical cavities, in petrous bone cholesteatomas and in meningoencephalic herniations. Recurrence of cholesteatoma was seen in only 4 (1.7%) cases. Other minor postoperative complications like wound dehiscence and infection of fat in the cavity etc occurred in 13 patients (11.83%).

Conclusions: Subtotal petrosectomy permits obtaining a cavity isolated from the external environment, and when needed, it improves the access and visibility during the surgical procedure. Subtotal petrosectomy is a safe technique, with a low rate of complications.