Secondary Acquired Cholesteatoma: Presentation and Tympanoplasty Outcomes

James Clark, Allen Feng, Aisha Harun, Glendine Brown, Howard W. Francis

Research output: Contribution to journalArticlepeer-review


OBJECTIVE:: Comparing the clinical features and surgical outcomes of patients undergoing tympanoplasty for secondary acquired cholesteatoma (SAC) versus non-complicated tympanic membrane perforation (TMP). STUDY DESIGN:: Retrospective patient review. SETTING:: Tertiary-care, academic center. PATIENTS:: All 41 patients with diagnosis of SAC confirmed at surgery between January 1, 2007 and June 30, 2014, and an age-matched cohort consisting of patients with TMP. INTERVENTION(S):: Tympanoplasty using either medial or lateral graft techniques. MAIN OUTCOME MEASURE(S):: Resolution of perforation, SAC, and symptoms. RESULTS:: Comparison between the two cohorts failed to reveal significant differences in otologic symptomology, or presentation. There was no significant difference in the resolution of SAC (p?=?0.7) between the medial and lateral tympanoplasty techniques. Both techniques also had similar rates of success in the TMP cohort. The medial graft technique was significantly (p?=?0.008) more likely to result in a successfully repaired tympanic membrane in the TMP cohort compared with the SAC cohort. The Lateral graft technique demonstrated no significant difference in the likelihood of TMP and SAC resolution. CONCLUSION:: The presentation of SAC is similar to that of TMP despite being a separate clinical entity. A clinicianʼs ability to distinguish the two is important to mitigate the destructive potential of untreated SAC and correctly council patients on tympanoplasty success rates. This study was unable to demonstrate a significant difference in disease control between the medial and lateral tympanoplasty techniques, although potential advantages of each technique are discussed.

Original languageEnglish (US)
JournalOtology and Neurotology
StateAccepted/In press - Jun 3 2016

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Clinical Neurology
  • Sensory Systems


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