Effect of endoscope assistance in tympanomastoidectomy for lowering the rate of residual cholesteatoma: Results from 91 paediatric patients

Yaniv, Dan; Tzelnick, Sharon; Ulanovski, David; Hilly, Ohad; Raveh, Eyal

doi:10.1111/coa.13405

Cited by 8 publications

(6 citation statements)

References 11 publications

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“…Indeed, a significant improvement in the rate of complete cholesteatoma removal with KTP laser use has been demonstrated in the setting of a randomised, controlled trial, 22 whilst use of otoendoscopes has been shown in several studies to improve visualisation in difficult-to-access sites and in turn lower the rate of residual cholesteatoma. 23,24 Direct comparison of these techniques is certainly something that merits further investigation in future studies.…”

Section: Discussionmentioning

confidence: 99%

Canal wall down mastoidectomy with obliteration versus canal wall up mastoidectomy in primary cholesteatoma surgery

et al. 2019

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ObjectiveThis study sought to compare disease recidivism rates between canal wall up mastoidectomy and a canal wall down with obliteration technique.MethodsPatients undergoing primary cholesteatoma surgery at our institution over a five-year period (2013–2017) using the aforementioned techniques were eligible for inclusion in the study. Rates of discharge and disease recidivism were analysed using chi-square statistics.ResultsA total of 104 ears (98 patients) were included. The mean follow-up period was 30 months (range, 12–52 months). A canal wall down with mastoid obliteration technique was performed in 55 cases and a canal wall up approach was performed in 49 cases. Disease recidivism rates were 7.3 per cent and 16.3 per cent in the canal wall down with mastoid obliteration and canal wall up groups respectively (p = 0.02), whilst discharge rates were similar (7.3 per cent and 10.2 per cent respectively).ConclusionOur direct comparative data suggest that canal wall down mastoidectomy with obliteration is superior to a canal wall up technique in primary cholesteatoma surgery, providing a lower recidivism rate combined with a low post-operative ear discharge rate.

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Section: Discussionmentioning

confidence: 99%

Canal wall down mastoidectomy with obliteration versus canal wall up mastoidectomy in primary cholesteatoma surgery

et al. 2019

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“…In the last decade, endoscopic assistance or TEEA for acquired children cholesteatoma has been frequently applied even if the results are controversial ( Table 2 ) [ 16 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 ]. Two meta-analyses have been conducted on this topic [ 9 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

The Role of Endoscopic Assistance in Surgery for Pediatric Cholesteatoma in Reducing Residual and Recurrent Disease

Nassif,

Redaelli de Zinis

2024

Children

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The primary aim of this study was to evaluate long-term recurrent and residual disease after surgery for acquired cholesteatoma in children according to surgical approach. A total of 71 interventions performed on 67 pediatric patients were included in the study. Canal wall-up tympanomastoidectomy (CWUT) was performed in 31 ears (13 with endoscopic assistance), a transcanal esclusive endoscopic approach (TEEA) was used in 22, and canal wall-down tympanomastoidectomy (CWDT) was performed in 18. Overall, the cholesteatoma relapse rate estimated by the Kaplan–Meier method was 47 ± 6% at 12 years; the recurrent cholesteatoma rate was 28 ± 6% and the residual cholesteatoma rate was 26 ± 5%. The relapse rate according to surgical approach was 33 ± 11% for CWDT, 60 ± 9% for CWUT, and 40 ± 11% for TEEA (p = 0.04). The difference for recurrent disease was no recurrent disease for CWDT, 42 ± 9% for CWUT, and 32 ± 11% for TEEA (p = 0.01). The residual disease rate was significantly reduced with endoscopy: 42 ± 8% without endoscopy vs. 9 ± 5% with (p = 0.003). CWDT can still be considered in primary surgery in case of extensive cholesteatomas and small mastoid with poor pneumatization. TEEA can be recommended for small cholesteatoma not extending to the mastoid to reduce morbidity. Endoscopic assistance seems useful to reduce residual disease in CWUT, whereas it does not have a significant impact on preventing recurrent disease.

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“…Advances in otoendoscopy have yielded otoendoscopes with a diameter of 2.7 and 1.9 mm, which can pass through the narrow ear canal to increase the surgical field of vision, improve the surgical field clarity, and observe tissue from multiple angles at close range. [ 18 ] Otoendoscopy allows clear vision of the superior tympanum, facial recess, tympanum sinus, eustachian tube, and other concealed anatomical sites. Otoendoscopic ear surgery involves a small incision, which makes it easier to accept even for children scheduled for a second surgery.…”

Section: Discussionmentioning

confidence: 99%

Transcanal endoscopic treatment for congenital middle ear cholesteatoma in children

Zeng¹,

Meng

Yan

et al. 2022

Medicine

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To investigate the feasibility and efficacy of transcanal endoscopic treatment for congenital middle ear cholesteatoma in children. Eleven children diagnosed with congenital middle ear cholesteatoma, who underwent total ear endoscopic surgery under general anesthesia, were included from the Huazhong University of Science and Technology Union Shenzhen Hospital between January 2016 and December 2020. We retrospectively analyzed their operation process and surgical complications through the surgical video; moreover, we compared the pre- and postoperative hearing outcomes. One child underwent a planned second operation to reconstruct the ossicular chain. At 6 postoperative months, all 11 children underwent reexamination. There was no significant change and a significant decrease in the mean bone and air conduction hearing thresholds, respectively (P > .05 and P < .05); moreover, there was a significant reduction in the air–bone conduction difference (P < .05). Further, the air–bone conduction difference was reduced to >20 dB and >10 dB in 11 and 7 children, respectively. Follow-up of the children did not reveal sensorineural deafness, facial paralysis, and other serious complications; further, there were no cases of recurrence. Transcanal endoscopic treatment for congenital middle ear cholesteatoma in children is feasible, minimally invasive, and functional.

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Effect of endoscope assistance in tympanomastoidectomy for lowering the rate of residual cholesteatoma: Results from 91 paediatric patients

Cited by 8 publications

References 11 publications

Canal wall down mastoidectomy with obliteration versus canal wall up mastoidectomy in primary cholesteatoma surgery

Canal wall down mastoidectomy with obliteration versus canal wall up mastoidectomy in primary cholesteatoma surgery

The Role of Endoscopic Assistance in Surgery for Pediatric Cholesteatoma in Reducing Residual and Recurrent Disease

Transcanal endoscopic treatment for congenital middle ear cholesteatoma in children

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