This study reviews 57 papers dealing with the issue of hearing preservation in vestibular schwannoma surgery published in otolaryngologic and neurosurgical literature between theyears 1977 and 1994. The authors', in this review, have made an attempt to verify whether the claims of hearing preservation are real, whether there is a price to be paid in terms of morbidity and whether there are univocal criteria for reporting results. The review shows that there is a wide disarray in reporting hearing results and the claims of hearing preservation are often unreal and misleading. On retabulating the results of a few series according to the minimal prerequisites for normal hearing (PTA ≤3O dB and SDS ≥70 per cent) and according to other various commonly reported criteria, it became evident that rates of hearing preservation differeda lot depending upon criteria. While any measurable hearing could be preserved in many cases, only a few had normal hearing preserved.

Treating cholesteatoma in children is still controversial. This article reviews 93 cases of pediatric cholesteatoma operated on from 1983 to 1991 in the Gruppo Otologico, Placenza, Italy, and details the results in 83 children who underwent the intact canal wall technique. During second-stage surgery, residual cholesteatoma was detected in 38% of patients. Recurrent cholesteatoma was detected in 10% of patients treated with the intact canal wall technique. Residual cholesteatoma was seen in the middle ear cleft in 63%, in the epitympanum in 26%, and in the mastoid in 11% of cases. Social hearing level (< 25 dB) was achieved in 85% of cases with suprastructure, whereas only 53% of patients without suprastructure had these levels. In the treatment of cholesteatoma in children by use of the intact canal wall technique, a preplanned second-look operation is mandatory to eradicate the disease.

The objectives are to evaluate role of magnetic resonance imaging (MRI) in diagnosis of cholesteatoma and correlate imaging findings with intraoperative findings, and to emphasize of role of imaging in the follow-up of postoperative patients for differentiating residual/recurrent cholesteatoma from granulation/inflammatory tissue. In this prospective study, 31 patients were evaluated with a specific MRI protocol and high resolution computed tomography of the temporal bones. These included patients with a strong suspicion of having a cholesteatoma on clinical examination and postoperative cases on clinical follow up. Based on specific MRI findings, presence of cholesteatoma was reported in 17 out of 31 patients. All 31 patients underwent surgery and 19 patients had confirmed intraoperative cholesteatoma. This study shows high sensitivity of a specific sequence based MRI examination in detection of cholesteatoma and in differentiating cholesteatoma from postoperative inflammatory/granulation tissue. To the best of the author's knowledge, this is the first such study performed in the Indian Asian population.