Moderator, Dr. Victor Goodhill: This panel on residual and recurrent cholesteatomata has a provocative title, that tells us much about the disease and our continuing and persistent inadequacy in cholesteatoma surgery.
Dr. Horst Wullstein: When considering recurrent cholesteatoma, we have to search which kind of recurrence we have. First the type with residual matrix which was not completely removed by the first surgery.
The second type would be the annulus cholesteatoma, as I would like to call it.
Third is the transplant cholesteatoma.
Fourth, retraction cholesteatoma.
The first type is self-explanatory. The first surgery was not complete. The second type, annulus cholesteatoma, means that the skin of the meatus along the annulus was not completely taken away. So when we insert our graft, our fascia graft, or whatever it may be, it covers a very small area of skin. Generally, tissue does not take on skin; however, in cases where