Endoscopic exclusive transcanal approach to the tympanic cavity cholesteatoma in pediatric patients: our experience

Abstract

From 1996 to 1998 in Marseilles, we lectured two courses on Endoscopic Ear Surgery. Today, in the world, many congresses are organized. One of the important benefits of an endoscope compared to the microscope is the wide field of view during ear surgery. Altogether there are numerous applications in the surgery of the middle ear. The routine, which uses optical systems for all Tympanoplasties, familiarises the surgeon with the endoscopic anatomy and provides a training for him.

Management of Jugular Bulb Injuries during Endoscopic Ear Surgery: Our Experience

“…5 TEES is gaining popularity almost in every field of otologic surgery, including pediatrics and lateral skull base. [6][7][8] The main advantage is the enhanced visibility of the anatomy and pathology due to wide-angled view and the capability to look around the corner which permits to explore hidden recesses, such as the retro-and hypotympanum. 9 Nevertheless, the onehanded technique can be challenging for the surgeon and bleeding is a major concern.…”

Endoscopic transcanal approach to the middle ear for management of pediatric cholesteatoma

“…In comparison, Marchioni et al reviewed recidivism rates in 31 TEES patients versus 28 canal wall up mastoidectomy patients depending on mastoid involvement. Twenty‐five of these patients had second‐look procedures with residual rates 19.3% and 34.4%, respectively, with no significant difference in recurrence rates . Lastly, Hunter et al recently published a pediatric cholesteatoma case series of 76 ears, 29 of which used endoscopes to some degree and 47 which used microscopic‐only, and showed a 10.3% residual rate in endoscopic cases, or 20% of those undergoing revision surgery; however, acquired and congenital cholesteatomas were not separated.…”

“…9 Additionally, higher prevalence of otitis media and URIs in children increase growth factors that promote cholesteatoma growth. 10 Data suggests that the addition of the endoscopes may reduce rates of residual or recurrent cholesteatoma. 4,5,11 In recent years, we shifted our practice from endoscopic-assisted surgery (EES 1) to an entirely endoscopic approach to the middle ear for pediatric cholesteatoma (EES 2 and 3).…”

“…Audiological outcomes were not significantly different in our study between EES 1 and EES 2 and 3 groups, similar to other studies of EES within large pediatric populations. 6,10,11 One study showed statistically significant improvement in ABG in pre-and posttesting; however, there was no statistically significant difference in hearing outcomes based on surgery type. 1 Furthermore, the need for and success of ossiculoplasty are likely more related to extent of disease rather than the method of visualization.…”

Lateral Skull Base Approaches in Pediatric Skull Base Surgery

“…There are very few reports of endoscopic lateral skull base surgery, and the pediatric literature is currently predominantly reporting on the endoscopic management of the middle ear and mastoid cholesteatomas. [21][22][23] Marchioni et al described their experience with exclusive transcanal approach to pediatric middle ear cholesteatoma. They reported the feasibility of this approach for the management of middle ear cholesteatoma and ossicular reconstruction as well.…”