DOI: 10.14260/jemds/2014/3168 ORIGINAL ARTICLE J of Evolution of Med and Dent Sci/ eISSN- 2278-4802, pISSN- 2278-4748/ Vol. 3/ Issue 34/Aug 11, 2014 Page 9057 A STUDY OF INTACT CANAL WALL TECHNIQUE IN PAEDIATRIC CHOLESTEATOMA PATIENTS FOR 2YRS IN GGH, KURNOOL Mohammed Naveed Ahmed 1 , M. Mahendra Kumar 2 , A. Sesha Prasad 3 , S. Muneeruddin Ahmed 4 , M. Praveen Kumar 5 , C. V. Rao 6 , Aghiri Nagaraju 7 , B. Durga Prasad 8 HOW TO CITE THIS ARTICLE: Mohammed Naveed Ahmed, M. Mahendra Kumar, A. Sesha Prasad, S. Muneeruddin Ahmed, M. Praveen Kumar, C. V. Rao, Aghiri Nagaraju, B. Durga Prasad. DzA Study of Intact Canal Wall Technique in Paediatric Cholesteatoma Patients for 2yrs in GGH, Kurnooldz. Journal of Evolution of Medical and Dental Sciences 2014; Vol. 3, Issue 34, August 11; Page: 9057-9067, DOI: 10.14260/jemds/2014/3168 ABSTRACT: INTRODUCTION: The surgical treatment of cholesteatoma in paediatric age group has changed opinion many times in the evolution of cholesteatoma surgery. Intact canal wall technique allows provision for maintaining the depth of the middle ear and post- operative hearing is much better than in canal wall down procedure. Canal wall down method precludes regular cleaning of the large cavity left behind. In CWU method incidence of recurrent and residual CH are more than in CWD methods. It is more common because inspection of epi-tympanum and medial aspects of the ossicles is not possible in ICW procedures. As a result, the disease recurs within 6 to 12 months. MATERIALS AND METHODS: Fifty children attending the OPD of Government General Hospital Kurnool with CH, confirmed with CT scan are taken and subjected to ICW tympano-mastoidectomy with or without ossiculoplasty. They are followed for a period of 18 months for residual disease,auditory evaluation and otoscopic examination for graft take up. RESULTS: There was improvement in hearing in 78% of the patients. Graft healing was good in 80.85% of cases. Recurrence was seen in 19.15% of patients. 14% of the patients ICW had to be converted to a CWD procedure within 8 months. There were no reports of intra cranial complication in this series. CONCLUSION: ICW procedure in paediatric cholesteatoma gives better results if the disease is limited to the posterior mesotympanum and not beyond the auditus. Uneventful 18months follow up period was seen in 80.85% of the patients. Recurrent disease is less common if the mastoids are less pneumatized. Revision to CWD may be required in early recurrence; in this series it was 14% of the patients. KEYWORDS: Paediatric Cholesteatoma, ICW, CWD, Residual disease, Recurrent Cholesteatoma, Residual Cholesteatoma, Ossiculoplasty, Epitympanum, Mastoid cavity. INTRODUCTION: Paediatric Cholesteatoma often runs a malignant course, destroying the patient’s hearing and involving the surrounding structures, including the brain, thereby increasing the morbidity and mortality of those affected. Cholesteatoma is associated usually with attico-antral variety of CSOM, also called the dangerous variety due to its bone eroding properties and spreading to vital surrounding areas. Middle ear cholesteatoma is still in many ways not understood. In children, it has a more complex presentation. However cholesteatoma in children is so aggressive that it cannot be treated conservatively. There is little disagreement regarding its sinister threat. It can lead to a wide spectrum of complications, ranging from disabling facial paralysis Deka¹΁ 1983 and labyrinthine fistulae to life threatening Lepto -meningitis and brain abscess. Furthermore, bilateral disease, with a consequent hearing impairment may profoundly retard the development of speech and acquisition of linguistic skills (Holmes and Kunz, 1969).