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.