Abstract

Key points 1. With an ageing population, there is a higher prevalence of dementia and patients with conditions that require surgical management. 2. Patients with dementia undergoing surgery under general anaesthesia often have poorer outcomes than those without dementia. 3. Local anaesthetic otological surgery requires patient cooperation, and this may be challenging in patients with dementia. 4. Local anaesthetic surgery for cholesteatoma in patients with dementia in the presence of their primary carer in the operating room helps facilitate communication and aid patient cooperation. 5. Cholesteatoma surgery in patients with dementia requires a careful individualised perioperative plan.