Evaluation of Residual Disease Following Transcanal Totally Endoscopic vs Postauricular Surgery Among Children With Middle Ear and Attic Cholesteatoma.

JAMA Otolaryngology-- Head & Neck Surgery
Peter R Dixon, Adrian L James

Abstract

Transcanal totally endoscopic ear surgery (TEES) improves tympanic cavity visibility during cholesteatoma resection but does not readily permit 2-handed surgery, which is possible with a postauricular approach and use of an operating microscope. Improved visibility and 2-handed access may reduce rates of incomplete surgical clearance and residual cholesteatoma. To compare rates of residual cholesteatoma after TEES vs those after open surgery with a postauricular approach for initial disease limited to the middle ear and/or attic. This propensity score-matched cohort study considered a consecutive sample of 209 pediatric cases of cholesteatomas resected at a tertiary referral center between January 1, 2005, and December 31, 2017, by either TEES or postauricular approach. The 177 cases (84.7%) in 172 patients that were eligible for inclusion in the study had undergone at least 1 of the following assessments: second-look tympanoplasty, diffusion-weighted magnetic resonance imaging, or in-clinic follow-up examination at least 2 years after the operation. Ears were matched on the basis of the propensity score, a function of age, sex, comorbid diagnoses, etiology, disease extent, ossicular chain condition, presence or absence of tymp...Continue Reading

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Citations

Jul 24, 2020·JAMA Otolaryngology-- Head & Neck Surgery·Peter R Dixon, Adrian L James
Jul 24, 2020·JAMA Otolaryngology-- Head & Neck Surgery·Manuele CasaleVittorio Rinaldi
May 28, 2021·HNO·Adrian L James
Jul 6, 2021·The Journal of Laryngology and Otology·A MoffaM Casale
Jun 27, 2021·Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology·Adam KwinterAdrian L James
Jul 10, 2021·Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology·Nichtima ChayaopasAdrian James

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