Absolute indications for the CWD approach include unresectable disease, an unreconstructable posterior canal wall, failure of a first-stage canal wall up approach because of poor eustachian tube function, and inadequate patient follow-up [[25], [30]]. Keywords: tympanomastoid cholesteatoma; canal wall down mastoidectomy; residual disease; recurrence rate EN tympanomastoid cholesteatoma canal wall down mastoidectomy residual disease recurrence rate 1745 9 11/17/22 20221101 NES 221101 1. In addition, rates of recurrence following the typical two-stage intact canal wall operation were found to be comparable to a single-stage canal wall down operation. Kim et al., in 2010 in a retrospective comparative study of 171 patients who underwent canal wall up or down mastoidectomy (CWUM and CWDM), did not report any significant difference (10.9 dB vs. 13.5 dB, respectively) ( I p i = 0.21) in the postoperative ABG and patients' rate with an ABG less than 20 dB (58.6% vs. 68.4%; I p i = 0.25). [Extracted from the article]