Purpose: To identify factors predictive of OMCC recurrence, in order to propose appropriate management. Patients and methods: We conducted a retrospective study of 60 OMCC cases managed at the ENT department of the Habib Bourguiba University Hospital in Sfax over a period from January 2004 to December 2014. Results: Cure of the disease was observed in 42 ears (70%). Cholesteatomatous recurrence was observed in 17 ears. Univariate analysis showed that age over 35 years and hammerhead lysis on rock computed tomography (CT) were risk factors for recurrence, and that hammerhead lysis on rock CT and closed-technique tympanoplasty were risk factors for cholesteatomatous recurrence. Multivariate analysis showed that only filling of the facial recess was the independent predictive factor for occurrence of residual cholesteatoma. Conclusions: The choice of therapeutic strategy must be adapted to the patient's age, the initial extension of the cholesteatoma, and the quality of middle ear aeration.