الفهرس 
Aim of the workOnly 14 pages are availabe for public view
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Abstract
Cholesteatoma is a surgical disease for which the primary universally accepted goal is total eradication of cholesteatoma to obtain a safe, dry ear. The second objective is restoration or maintaining the functional capacity of the ear, the hearing. The third objective is to maintain a normal anatomic appearance of the ear if possible.Surgical management of cholesteatoma can be performed either by CWD or CWU techniques with their inherent benefits and drawbacks,but there is still an ongoing debate about the best choice.The technique that offers the best of the both (CWD and CWU ) would be one that allows temporary removal of the posterosuperior canal wall for safe eradication of cholesteatoma followed by reconstruction of the canal wall for good anatomical and physiological results.
In this study all patients suffered from chronic otitis media with cholesteatoma with the following exclusion criteria:
• Extensive destruction of the posterior canal wall and mastoid cortex.
• Low tegmen.
• Significant anterior or lateral sigmoid sinus.
• Only functioning ear.
• Labyrinthine fistula.
• Previous canal wall down mastoidectomy.
All patients were subjected to complete history taking, general examination, ENT examination with special attention to otomicroscopic and otoendoscopic examination, routine preoperative laboratory investigations, preoperative temporal bone CT scan and preoperative pure tone audiogram.
All patients were managed through the standard post-auricular approach by our chosen surgical technique with the principle of cutting the entire posterosuperior meatal wall as one piece by a microsagittal saw and then repositioning of this wall in its anatomical site after compelte eradication of cholesteatoma from the tympanic cavity,epitympanum,retrotympanu andmastoid with placing of bone paté in the attic and mastoid to hold the posterosuperior canal wall in place.
The postoperative follow up ranged from 7 to 19 months in the form of history taking, clinical assessment by otoendoscopic examination, radiological evaluation by postoperative follow-up CT scan after 6 months, audiological evaluation by postoperative follow-up pure tone audiogram after 6 months and staged second-look surgery.
Our chosen surgical technique provided excellent exposure of tympanic cavity, epitympanic and retrotympanic spaces for eradication of cholesteatoma similar to CWD procedures with the advantage of avoiding the troubles of postoperative mastoid cavity. Also, our chosen surgical procedure allowed restoration of near normal anatomy of the external auditory call with healing time similar to that of CWU procedures with the advantage of low recurrencse rate (5%).There were no serious intra- or post-operative complications,making our surgical technique an attractive alternative to the standered CWD and CWU procedures.