A posterior canal wall-up mastoidectomy (CWU) is performed for cholesteatoma. The surgical principle of leaving the posterior canal wall intact is BEST justified by which advantage?
- A Preserves the self-cleaning mechanism of the ear and allows hearing aid use ✓
- B Eliminates the need for cavity obliteration
- C Provides wider access to the attic for complete cholesteatoma removal
- D Reduces the risk of facial nerve injury
Correct answer: A. Preserves the self-cleaning mechanism of the ear and allows hearing aid use
Explanation
Canal wall-up (closed) mastoidectomy retains the posterior canal wall, preserving the external auditory meatus geometry; this maintains the natural self-cleaning epithelial migration and allows subsequent hearing aid fitting without dealing with a large mastoid cavity. The main disadvantage is higher residual cholesteatoma rates and need for second-look surgery, not better cholesteatoma access. Facial nerve risk is not significantly different between CWU and CWD.
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.