CHOLESTEATOMA BY INSIDE OUT CANA WALL DOWN TECHNIQUES IN GOVERNMENT TERIARY CARE HOSPITALS

A prospective study comprising of 50 patients with cholesteatoma on whom the inside out canal wall down mastoidectomy was performed. This study aimed at the efficacy of the technique in complete eradication of the disease as well as its usefulness in decreasing cavity problems. Present study the age group ranged from 8 to 60 years. The mean age in this study was 22.34 years. The male to female ratio in this study was 2.125:1. Cholesteatoma was seen in the posterosuperior quadrant of the tympanic membrane in 54% cases, while attic cholesteatoma was seen in 42% cases. The remaining 4% had a central perforation. The median air conduction threshold was 42.5dB in the present series. The median air bone gap in this series was 30dB. Intraoperatively 76% of the cases had a necrosed incus. Malleus was necrosed in 30% and stapes superstructure was necrosed in 40% of our cases.44 patients (90%) had regular follow up. Overall success rate was 93.18% in this series. The average postoperative air bone gap in the present series was 18.03 dB and the average hearing gain was found to be 10.66dB. 84% of patients had a problem free cavity while excessive wax and debris was seen in 9%. Discharge due to persistence of disease was seen in 7%.