Background and ObjectivesZZTranscanal antrotomy approach (TCA) enables not only good exposure but also minimal incision approach required for pediatric congenital cholesteatoma (CC). The addition of "CO2 laser enabled ablation and resection (CLEAR)" would facilitate safe and complete removal of CC from stapes. This study evaluates the clinical results of surgically removing CC through TCA with CLEAR (minimal incision approach with CO2 laser, MICL). Subjects and MethodZZThe medical records of patients who underwent endaural extended tympanostomy, MICL, or postauricular approach for CC removal from January 2009 to September 2011 were reviewed in this study. ResultsZZMICL was performed in 37 patients of Potsic I, II CC. It was effective in surgical exposure and reducing the chance of residual CC. MICL could satisfactorily avoid postauricular tympanomastoidectomy, which allowed preservation of healthy mastoid air cells for almost all Potsic III CC, including posterior CC (14 patients). MICL was also useful for 6 cases of Potsic IV CC that extended beyond the incus posterosuperiorly to the auditus ad antrum. Children were not committed to second look operation because the attic was exteriorized with-out the cavity problem and the complete removal of CC from the stapes was facilitated with CLEAR. ConclusionZZMICL enabled sufficient exposure with less invasive approach as well as complete CC removal, which reduced the postoperative complications and needs for second look operation. This surgical technique could be widely used for Potsic stage I, II, III, and some IV CC.

Leiomyoma is the most common benign neoplasm of the uterus and gastrointestinal tract, but it is rare in the oral cavity. Also, its occurrence in the tongue is very rare because there is so little smooth muscle tissue present in this region. Clinically, oral leiomyoma usually grows slowly and is generally a non-ulcerated, small (1 to 2 cm), painless, sessile, firm and superficial nodule like lesion, although several authors have reported painful lesions. The diagnosis and treatment of oral leiomyoma is possible with complete surgical excision and histological studies by special stains. Recently, we experienced a 42-year-old woman with 6 month history of protruding tongue mass. She underwent surgical excision and the final pathological result confirmed it to be vascular leiomyoma. We report this case with a review of the related literatures.

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