The optimal surgical treatment for canal‐wall‐up mastoidectomy of external auditory canal cholesteatoma

Abstract Purpose To explore the optimal surgical excision treatment for external auditory canal (EAC) cholesteatoma involving the posterior wall and partial mastoid process. Methods This study included 115 inpatients (152 ears) diagnosed with EAC cholesteatoma involving posterior wall and partial mastoid from April 2022 to April 2024. Each patient underwent a canal‐wall‐up mastoidectomy, canaloplasty, and tympanoplasty. Preoperative clinical symptoms and hearing were compared with postoperative outcomes during follow‐ups. Results All patients achieved a dry‐ear status and remained relapse‐free over the 0.5–2 years' follow‐ups. The most salient improvements were observed in hearing loss, oltagia, and aural fullness after the surgical intervention. Conclusion For EAC cholesteatoma with the posterior canal wall and partial mastoid invasion, canal‐wall‐up mastoidectomy with reconstruction of the posterior canal wall is preferable, provided there are no severely extensive cholesteatomas present in the mastoid.