PMID: 19128580Jan 9, 2009Paper

Endoscopic management of acquired cholesteatoma: our experience

Journal of Otolaryngology - Head & Neck Surgery = Le Journal D'oto-rhino-laryngologie Et De Chirurgie Cervico-faciale
Livio PresuttiMatteo Alicandri-Ciufelli

Abstract

The purpose of this study was to examine the utility of using an endoscope in cholesteatoma surgery and to demonstrate how it allows a reduction in the incidence of residual disease. Thirty-two ears with acquired cholesteatoma (primary) were resected. Twenty cases were resected using a canal wall up (CWU) technique and six cases using a canal wall down (CWD) technique, and in six cases, a transcanal tympanotomy-atticotomy was performed. All of the patients in our study group underwent explorative and operative endoscopic ear surgery complementary to use of the operating microscope to uncover and remove residual cholesteatoma. In the primary surgery after completion of microscopic cleaning, the overall incidence of intraoperative residual disease detected with the endoscope was 37.5%. The sinus tympani was the most common site of intraoperative residual disease, followed by the anterior epitympanic recess and protympanum. Of the 20 CWU cases, 12 second-look endoscopies were performed. Two residuals were identified, both in the sinus tympani. No significant complications were associated with the 32 endoscopic procedures. The endoscope allowed a better understanding of cholesteatoma and improved eradication of residual disease fro...Continue Reading

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