In a 'canal wall up' (combined approach tympanoplasty) technique for cholesteatoma, what is the primary advantage over the 'canal wall down' technique?
- A Lower recurrence rate of cholesteatoma
- B Preservation of the posterior canal wall allowing a self-contained middle ear cavity amenable to better hearing reconstruction ✓
- C No need for second-look surgery
- D Lower risk of facial nerve injury
Correct answer: B. Preservation of the posterior canal wall allowing a self-contained middle ear cavity amenable to better hearing reconstruction
Explanation
Canal wall up (CWU) preserves the posterior bony canal wall, maintaining normal ear canal anatomy, allowing use of a closed middle ear cavity that is more favorable for hearing reconstruction (ossiculoplasty) and does not require lifelong cavity care. However, CWU carries a higher risk of residual/recurrent cholesteatoma (requiring planned second-look at 6–12 months) compared to canal wall down (CWD), which creates an open mastoid bowl with lower recurrence but requires regular aural toilet.
Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.