(A850) Preserving Facial Function in Recurrent Cholesteatoma with Lateral Canal Dehiscence: A Case Report

Introduction: Cholesteatoma is a chronic, destructive process of the middle ear. Despite multiple surgical interventions, recurrence can occur, especially in cases involving complex anatomical variations. This case report presents a patient with recurrent cholesteatoma and an extensive lateral canal dehiscence, highlighting the surgical challenges and management strategies.

Methods: This case report focuses on a 53-year-old woman who had a mastoidectomy in 2018 due to cholesteatoma. She was scheduled for surgery in 2024 after a new MRI revealed recurrent cholesteatoma, lateralvcanal dehiscence, and a lateral semicircular canal fistula. We reviewed the patient's medical records, including preoperative assessments, surgical notes, and post-op follow-ups. We also did a thorough literature search on PubMed using keywords like 'cholesteatoma', 'lateral canal dehiscence', 'facial nerve', and 'recurrent surgery' to find related research.

Results: The patient presented with recurrent cholesteatoma following a previous mastoidectomy performed in 2018. Subsequent surgery was undertaken to address the recurrent cholesteatoma and a pre-existing semicircular canal fistula. Microscopically the cholesteatomatous tissue was successfully removed, and the dehiscence was closed using bone wax and fascia. Postoperative MRI demonstrated no evidence of residual cholesteatoma. The patient was discharged from the hospital without experiencing vertigo or hearing loss.

Conclusions: This case highlights the challenges of managing recurrent cholesteatoma, particularly when complicated by extensive lateral canal dehiscence. Careful preoperative planning, intraoperative decision-making, and close postoperative follow-up are essential for optimal patient outcomes.