Objectives: We present the surgical techniques and outcomes of mastoid surgery under local anesthesia in patients who were unfit for general anesthesia
Methods: Five tertiary-refeiTed patients with multiple comorbidities and failed conservative treatment for chronic otitis
media were operated on under local anesthesia. No sedation was administered. The principles of cholesteatoma surgery
were observed, but the technique was adapted to keep surgical time to a minimum.
Results: None of the patients had perioperative problems, and all have dry, waterproof ears with preservation of hearing
after surgery. So far, none of the patients have had recurrent or residual disease.
Conclusions: Cholesteatoma surgery can be successfully performed with a local anesthetic in patients who are medically
unfit for general anesthesia. Surgery requires a good coordination of the operating team in order to shorten the operat-
ing time. Otologists should develop and maintain their skills by performing ear surgery with local anesthetic on a regular
basis.