ObjectiveToinvestigatetheadvantagesofcanalwallreconstruction(CWR)mastoidectomy,asingle-stagetechniqueforcholesteatomaremovalandposteriorexternalcanalwallreconstruction,overtheopenandclosedproceduresintermsofcholesteatomarecurrence.Methods:BetweenJune2002andDecember2005,38patients(40ears)withcholesteatomawereadmitedtoSunYat-SenMemorialHospitalandreceivedsurgicaltreatments.Ofthesepatients,25weremalewithagesrangingbetween11and60years(mean=31.6years)and13werefemalewithagesrangingbetween20and65years(mean=38.8years).Canalwallreconstruction(CWR)mastoidectomywasperformedin31earsandcanalwalldown(CWD)mastoidectomyin9ears.Conchacartilagewasusedforearcanalwallreconstructionin22ofthe31CWRproceduresandcorticalmastoidbonewasusedintheremaining9cases.ResultsAt0.5to4yearsfollowup,allbutonepatientsremainedfreeofsignsofcholesteatomarecurrence,i.e.,noretractionpocketorcholesteatomamatrix.Onepatient,asmoker,neededrevisionsurgeryduetocholesteatomarecurrence1.5yearaftertheinitialoperation.Therecurrenceratewastherefore3.2%(1/31).CholesteatomarecurrencewasmonitoredusingpostoperativeCTscanswheneverpossible.Inthecasethatneededarevisionprocedure,aretractionpocketwasidentifiedbyotoendoscopyintheparsflacidaareathateventuallyevolvedintoacholesteatoma.Apocketextendingtotheepitympanumfilledwithcholesteatomamatrixwasconfirmedduringtherevisionoperation,Adecisiontoperformamodifiedmastoidectomywasmadeasthepatientrefusedtoquitsmoking.Themeanair-bonegapinpuretonethresholdwas45dBbeforesurgeryand25dBafter(p<0.05).Therewasnodifferencebetweenusingconchacartilageandcorticalmastoidboneforthereconstructionregardingair-bonegapimprovement,CTfindingsandotoendoscopicresults.ConclusionCWRmastoidectomycanbeusedformostpatientswithacquiredmiddleearcholesteatoma,inc
