Transcanal Endoscopic Ear Surgery for Congenital Cholesteatoma: A Preliminary Report

Sun, Wan‐Hsuan; Kuo, Chin‐Lung; Huang, Tzu-Chin

doi:10.24983/scitemed.aohns.2017.00025

Cited by 6 publications

(9 citation statements)

References 9 publications

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“…It would seem reasonable to assume that the aforementioned benefits would apply to endoscopic ear surgery. Other benefits of endoscopic ear surgery that have been postulated are a reduction of residual disease in cholesteatoma surgery, 4–11 reduction of surgery time, 12–14 preserving functional anatomy, 15–18 and better cost‐effectiveness 10,19,20 . Comparable results in myringoplasty have been demonstrated, suggesting that the outcome remains equal 21 …”

Section: Introductionmentioning

confidence: 99%

Pain After Ear Surgery: A Prospective Evaluation of Endoscopic and Microscopic Approaches

et al. 2020

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Objectives/Hypothesis Assumed advantages of a minimally invasive endoscopic transmeatal approach in ear surgery are less postoperative pain, faster healing, and preservation of functional anatomy. We evaluated pain after ear surgery and compared endoscopic transmeatal, microscopic endaural, and retroauricular approaches. Study Design Prospective cohort study. Methods A prospective evaluation of pain during 3 weeks after ear surgery was performed. Three groups were defined: endoscopic transmeatal, microscopic endaural, and retroauricular. Data from 20 fully completed questionnaires (Brief Pain Inventory–Short Form) per group were analyzed with Bayesian and frequentist statistics. Results For all approaches, low pain scores were found, not exceeding 4 on a scale of 0 to 10. Analysis of the worst, least, and average pain scores documented per 24 hours showed no statistically significant difference nor equality between groups. With Bayesian statistics, a Bayes factor of 1.07, 0.25, and 0.51 was found, respectively. With frequentist statistics a p value of .092, .783, and 0.291 was found, respectively. Small, but statistically significant, differences were found for sleep, natural sleeping position, normal work, and pain medication taken. The location of pain correlates with the incision site. Conclusions The results of this study show that the surgical approach has no clinically relevant influence on postoperative pain after ear surgery. The statistically significant differences on natural sleeping position, sleep, normal work, and amount of pain medication taken are small and should be interpreted with caution. Therefore, these should not be decisive factors in the choice of surgical approach in ear surgery. Level of Evidence 3 Laryngoscope, 131:1127–1131, 2021

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Section: Introductionmentioning

confidence: 99%

Pain After Ear Surgery: A Prospective Evaluation of Endoscopic and Microscopic Approaches

et al. 2020

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“…4 In the management of pediatric CC, transcanal endoscopic ear surgery (TEES) has been shown to provide a good alternative to traditional microscopic ear surgery. 5 Here, we report the first known case of a patient with CC in the anterior epitympanic recess and discuss the utility of the endoscopic removal of CC in hidden areas within the middle ear.…”

Section: Introductionmentioning

confidence: 97%

Endoscopic Surgery of Congenital Cholesteatoma in the Anterior Epitympanic Recess: A Case Report of a Rare Location

2020

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Congenital cholesteatoma is a whitish mass in the middle ear medial to an intact tympanic membrane. It is often without symptoms and therefore incidentally diagnosed. Pediatric congenital cholesteatoma generally starts as a small pearl-like mass in the middle ear cavity that eventually expands to involve the ossicles, epitympanum, and mastoid. The location, size, histopathological type, and extent of the mass must be evaluated to select the appropriate surgical method. Although microscopic ear surgery has traditionally been performed to remove congenital cholesteatoma, a recently introduced alternative is endoscopic surgery, which allows a minimally invasive approach and has better visualization. Here, we report the first known case of a patient with congenital cholesteatoma in the anterior epitympanic recess and discuss the utility of an endoscopic approach in the removal of a congenital cholesteatoma in the hidden area within the middle ear.

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“…Upper airway infection and otitis media could increase growth factors or matrix metalloproteinase, which make cholesteatoma more invasive. This can erode the surrounding bone in the middle ear and mastoid cavity, possibly furthering damage to the skull base or even to the brain [ 1 , 2 ]. Currently, microscopic ear surgery and endoscopic ear surgery are the main streams of the surgical treatment of cholesteatoma.…”

Section: Introductionmentioning

confidence: 99%

The Efficacy of DW and T1-W MRI Combined with CT in the Preoperative Evaluation of Cholesteatoma

Sun

Fan

Huang

2022

JPM

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Objective: This study aims to assess the efficacy of diffusion-weighted (DW) and T1-weighted (T1W) magnetic resonance imaging (MRI) combined with high-resolution computed tomography (HRCT) (together as DW-T1W-CT) in the preoperative evaluation of the presence and extent of cholesteatoma, which helps determine whether a patient is suitable for transcanal endoscopic ear surgery (TEES). Methods: This retrospective study included 35 patients (18 male and 17 female) aged from 2 to 81 years diagnosed with chronic otitis media with or without cholesteatoma, who had received surgical treatment and a preoperative MRI and HRCT during the period of December 2015 to December 2020 at Cathay General Hospital. We compared the preoperative DW-T1W-CT findings with the intraoperative findings and final pathologic diagnosis. The accurate predictive value was evaluated using the presence of cholesteatoma and its extent. Results: Regarding the efficacy of detecting cholesteatoma, we found a sensitivity of 92% (23/25 cases with cholesteatoma), a specificity of 90% (9/10 cases without cholesteatoma), and an overall accurate predictive value of 91.4% (32/35) by using combined DW-T1W-CT imaging. With regard to evaluating the extent of cholesteatoma, the combined DW-T1W-CT images obtained an accurate predictive value of 84% (21/25 cases of cholesteatoma). Conclusion: Combined DW-T1W-CT has been proven to be a reliable tool in detecting the presence of cholesteatoma. It is also useful in preoperatively depicting the extent of cholesteatoma, which is crucial for determining whether a patient is suitable for TEES, aiding in surgical planning and patient consultation.

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Transcanal Endoscopic Ear Surgery for Congenital Cholesteatoma: A Preliminary Report

Cited by 6 publications

References 9 publications

Pain After Ear Surgery: A Prospective Evaluation of Endoscopic and Microscopic Approaches

Pain After Ear Surgery: A Prospective Evaluation of Endoscopic and Microscopic Approaches

Endoscopic Surgery of Congenital Cholesteatoma in the Anterior Epitympanic Recess: A Case Report of a Rare Location

The Efficacy of DW and T1-W MRI Combined with CT in the Preoperative Evaluation of Cholesteatoma

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