Improvement of otoendoscopic surgery for epitympanic cholesteatoma invading the mastoid

Abstract

Background: In recent years, the otoendoscopic surgery for epitympanic cholesteatoma has achieved great development, but it still has some disadvantages.

Objective: This work aims to improve otoendoscopic surgery for epitympanic cholesteatoma invading the mastoid to retain the normal structure of the middle ear as much as possible.

Methods: We classified the patients according to the lesion scope and applied different strategies of using the combination of otoendoscope and microscope. The surgery was improved and the recurrence and residual of middle ear cholesteatoma after operation were observed preliminarily.

Results: Forty-six patients with middle ear cholesteatoma accepted surgical treatment, including 10 cases of independent otoendoscopic surgery, 29 cases of otoendoscope–microscope combined surgery, and seven cases of microscopic surgery assisted with an otoendoscope. All cases were treated with canal-up cholesteatoma surgery. The postoperative recurrent rate was 4/46.

Conclusion: We improved existing otoendoscopic surgery to reduce or avoid bony defects of the acoustic meatus, and then decreased the proportion of canal-down surgery.

Chinese abstract

背景：近年来, 鼓室内胆脂瘤的耳内镜手术取得了很大的发展, 但仍存在一些不足。

目的：本研究旨在改善扩散至耳乳突的鼓室内胆脂瘤的耳内镜手术, 以便尽可能保留中耳的正常结构。

方法：根据病变范围对患者进行分类, 采用内镜和显微镜相结合的不同方法。改善手术方式, 初步观察术后中耳胆脂瘤的复发和残留情况。

结果：46例中耳胆脂瘤患者接受手术治疗, 其中10例采用独立内镜手术治疗, 29例采用内窥镜 - 显微镜联合手术治疗, 7例采用显微手术辅助内镜治疗。所有病例均采用胆管胆脂瘤手术治疗。术后复发率为4/46。

结论：我们改进了现有的内窥镜手术, 以减少或避免耳道骨损伤, 从而减少根管手术的比例。

Keywords:

• Otoendoscope
• microscope
• epitympanic cholesteatoma
• transcanal approach

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Additional information

Funding

This study was supported by National High-tech R&D Program of China (863 Program) [2014AA020510]; the National Natural Science Foundation of China [NSFC # 81271082 and 81400472].